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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)
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| Application Summary: Diploma in Nautical Science |
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| Dossier ID: DNS2049961 |
Name: Vipul Kumar Dubey |
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Address: Suryanagar Powai Road Vikhroli-W Mumbai-83 Suryanagar Powai Road Vikhroli-W Mumbai-83 |
| Telephone No.: |
Mobile no: 9324541074 |
| E-mail: dubeyvipulkumar16@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 200 (Includes Convenience fee of ₹ ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 304854791 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2049961 are true and correct. |
| Signature of Candidate |
Signature of Parent/Guardian |
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___________________ |
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| Date ________________ |
Date ________________ |
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| Please quote your dossier id and full name for any future correspondence |
| Please ensure that you send the following documents with your application. |
- Write Application for Diploma in Nautical Science, Dossier ID on the envelope
- Print the application form duly filled
- Print the application summary duly signed where indicated
- Three identical recent passport size photographs with name & dossier id written at the back
- Self – attested copies of Class X marksheet and Pass Certificate
- 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)
- 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)
- Self – attested copies of school leaving certificate / transfer certificate (for proof of age)
- Self – attested copy of birth certificate (for proof of age and place of birth)
- Copies of sports and extra-curricular activities (Class VIII and above only)
- Copy of Class XII board exam admit card for those appearing in 2020
- 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)
- Please keep a copy of the form for your reference for communicating with the Institute
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| 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. |
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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
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| Applicant's Personal Information: |
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| Full Name as on Class XII Marksheet/Pass Certificate: Vipul Kumar Dubey |
| Mother's Name: Sarita Dubey |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 06 Mar 2001 |
Nationality: Indian |
| Place of Birth: Jaunpur |
Personal Identification Mark: NA |
| Blood Group: B + |
Address for Communication: Suryanagar Powai Road Vikhroli-W Mumbai-83 Suryanagar Powai Road Vikhroli-W Mumbai-83 |
| State: Maharashtra |
Country: India |
| Pin: 400083 |
City/District: Mumbai |
| Mobile no: 9324541074 |
Telephone No. with STD code: |
| Aadhar Card No:357604421973 |
E-mail: dubeyvipulkumar16@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: Sabhapati Dubey |
Relationship with candidate: Father |
| Parents Date of Birth: 15 Jul 1971 |
Parent's/Guardian's Occupation/Designation: Priest |
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| Office Address: |
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| Address: - - |
| Country: India |
State: Maharashtra |
| City/District: Mumbai |
Pin: 400083 |
| Tel: |
Mobile no.: 9819679671 |
| Fax: |
Email: dubeyneha411@gmail.com |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2016 |
Year of Passing: 2018 |
| Board: Uttar Pradesh |
Board: CBSE |
| School: S D M H S S Sirkina Singhramau Jaunpur |
School: K V Bhandup Mumbai-83 |
| City: Jaunpur |
City: Mumbai |
| English %: 87 |
Board Roll No./Seat No.: 4650135 |
| Aggregate Percentage: 86 |
School/College Code: 400078 |
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Centre code: 4608 |
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Address of School/College: Bhandup Mumbai-83 |
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Pin: 400083 |
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Contact Nos: |
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Email: kvbhandup78@gmail.com |
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Aggregate Percentage: 69 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
100 |
78 |
78 |
| Chemistry |
100 |
65 |
65 |
| Mathematics |
100 |
55 |
55 |
| Physics, Chemistry & Mathematics combined Percentage: |
66 |
| English |
100 |
63 |
63 |
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| IMU CET Application Number: |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparation of IMUCET |
| Why do you wish to join TMI?: At present it is the best Maritime college for academic training and placement percentage. |
| What are your hobbies?: Always on time,listening music,nature loving |
| What are your strengths?: My parents |
| What are your weaknesses?: Due to some little time disturbance,sometimes i lost my full day time |
| How do you intend to meet the expenses of this program?: Own Resources,Bank Loan |
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| Review you documents: |
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Birth certificate
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DGS Approved Medical Fitness Certificate not uploaded
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Class X marksheet
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School leaving certificate not uploaded
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Class XII admit card not uploaded
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Class XII marksheet
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| Declaration
I hereby declare that all the statements made above are true and correct. |
Signature of Candidate |
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Date ________________ |
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