Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science 2020)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2049803 Name: Shahnawaz
  Address: Ward No. 7 Behind Tahsil Salempur Deoria Uttar Pradesh
Telephone No.: Mobile no: 7084655580
E-mail: shahnwaja037@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 304601396
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049803 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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Date ________________ Date ________________
 

 

Please quote your dossier id and full name for any future correspondence
Please ensure that you send the following documents with your application.
  1. Write Application for Diploma in Nautical Science, Dossier ID on the envelope
  2. Print the application form duly filled
  3. Print the application summary duly signed where indicated
  4. Three identical recent passport size photographs with name & dossier id written at the back
  5. Self – attested copies of Class X marksheet and Pass Certificate
  6. Self – attested copies of Class XII marksheet and Pass Certificate (Candidates appearing for Class XII exam in 2020 may submit these copies after declaration of results)
  7. Self – attested copies of class XII marksheet downloaded from internet (Candidates appearing for Class XII exam in 2020 may submit these copies after declaration of results)
  8. Self – attested copies of school leaving certificate / transfer certificate (for proof of age)
  9. Self – attested copy of birth certificate (for proof of age and place of birth)
  10. Copies of sports and extra-curricular activities (Class VIII and above only)
  11. Copy of Class XII board exam admit card for those appearing in 2020
  12. A non-refundable Demand Draft of Rs. 200/- favouring “Tolani Maritime Institute” payable at Pune. Write your name, dossier id and contact details on the reverse of the Demand Draft (Kindly ignore if you have paid online)
  13. Please keep a copy of the form for your reference for communicating with the Institute

Send Duly filled application forms to:

Admissions Cell (DNS)
Tolani Maritime Institute
Talegaon-Chakan road, Induri,
Talegaon, Pune, Pin- 410507
Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2020

 
  Dossier ID: DNS2049803
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Shahnawaz
Mother's Name: Amtun Nisha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Jan 2002 Nationality: Indian
Place of Birth: Salempur Personal Identification Mark: Mark on chin
Blood Group: A + Address for Communication: Ward No. 7 Behind Tahsil Salempur Deoria Uttar Pradesh
State: Uttar Pradesh Country: India
Pin: 274509 City/District: Deoria
Mobile no: 7084655580 Telephone No. with STD code:
Aadhar Card No:724127868304 E-mail: shahnwaja037@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Dilzan Ansari Relationship with candidate: Father
Parents Date of Birth: 01 Aug 1968 Parent's/Guardian's Occupation/Designation: Farmer
   
Office Address:
   
Address: Ward No. 7 Behind Tahsil Salempur Deoria Uttar Pradesh
Country: India State: Uttar Pradesh
City/District: Deoria Pin: 274509
Tel: Mobile no.: 7565833530
Fax: Email: shahnwajsk1@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: St Mary Inter College School: St Mary Inter College
City: Lucknow City: Lucknow
English %: 76 Board Roll No./Seat No.: 5716677
Aggregate Percentage: 76 School/College Code: 54622
  Centre code: 5262
  Address of School/College: Sector 3 Jankipuram Ext. Lucknow
  Pin: 226021
  Contact Nos:
  Email: smicedu@gmail.com
  Aggregate Percentage: 82
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 75 75
Chemistry 100 89 89
Mathematics 100 76 76
Physics, Chemistry & Mathematics combined Percentage: 80
English 100 86 86
   
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
2015 NMTSE National 26
2019 Prefect School Captain
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I play cricket daily. I go for jogging daily. I prepare for NDA and other defence exam. Sometimes I prefer cooking food by watching its recipe on Youtube.
Why do you wish to join TMI?: At present this is the best Maritime Academy in India with maximum training, knowledge and placement percentage.
What are your hobbies?: Playing cricket and listening to the music
What are your strengths?: My strength is my stability and punctuality.
What are your weaknesses?: I am talkative and straight forward.
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate Class X marksheet School leaving certificate Class XII admit card Class XII marksheet
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

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Date ________________

 
Print Summary and Application Form