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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: DNS2050029 |
Name: Ankit Kumar Mishra |
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Address: Adarsh Nagar road no.3b Samastipur,Bihar |
Telephone No.: |
Mobile no: 9199799044 |
E-mail: ankitmishra1552000@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: 304977365 |
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Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050029 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: Ankit Kumar Mishra |
Mother's Name: Brijwala Mishra |
Gender (M/F): Male |
Marital Status (Single/Married): Single |
Date of Birth (DD/MM/YY): 15 Jan 2002 |
Nationality: Indian |
Place of Birth: Samastipur |
Personal Identification Mark: Mole on back of neck |
Blood Group: B + |
Address for Communication: Adarsh Nagar road no.3b Samastipur,Bihar |
State: Bihar |
Country: India |
Pin: 848101 |
City/District: samastipur |
Mobile no: 9199799044 |
Telephone No. with STD code: |
Aadhar Card No:744643365302 |
E-mail: ankitmishra1552000@gmail.com |
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Guardian's Particulars: |
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Name of Parent/Guardian: Deepak Mishra |
Relationship with candidate: Father |
Parents Date of Birth: 15 Feb 1981 |
Parent's/Guardian's Occupation/Designation: Private job |
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Office Address: |
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Address: Saharsa road, maheskhunt Khagaria |
Country: India |
State: Bihar |
City/District: Khagaria |
Pin: 851213 |
Tel: |
Mobile no.: 9708689635 |
Fax: |
Email: ankitmishra1552000@gmail.com |
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Education and Academic Record :
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Class X: - |
Class XII: - |
Year of Passing: 2017 |
Year of Passing: 2019 |
Board: CBSE |
Board: CBSE |
School: Holy Mission High school |
School: D.A.V Public School |
City: Samastipur |
City: Samastipur |
English %: 85 |
Board Roll No./Seat No.: 7662656 |
Aggregate Percentage: 93 |
School/College Code: 50164 |
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Centre code: 7178 |
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Address of School/College: Harpur ailoth |
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Pin: 848101 |
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Contact Nos: |
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Email: davsamastipurbr046@gmail.com |
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Aggregate Percentage: 70 |
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Details of Marks Secured in (10+2) Examination - |
SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
Physics |
100 |
62 |
62 |
Chemistry |
100 |
74 |
74 |
Mathematics |
100 |
58 |
58 |
Physics, Chemistry & Mathematics combined Percentage: |
64.67 |
English |
100 |
66 |
66 |
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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 ?: Joining vocational course |
Why do you wish to join TMI?: TMI is a prestigious institution which can definitely guide me to attain quality education in the relevant field, also hope to get placed after completion of course |
What are your hobbies?: My hobbies are playing handball, volleyball and watching movies |
What are your strengths?: My biggest strength is positive attitude towards accepting any thing which is right. Leading team, helping others , punctuality, hard work ,caring are other strength of mine . I love to have other suggestions |
What are your weaknesses?: I am of very shy nature, at times I get sluggish, |
How do you intend to meet the expenses of this program?: Bank Loan |
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Review you documents: |
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 not uploaded
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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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