Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
Lateral Entry - B.Tech (Marine Engineering)

APPLICATION FOR ADMISSION - 2020

 
Dossier ID: LTE2050963
 
Applicant's Personal Information:
 
Full Name as on Diploma Marksheet/Pass Certificate: Prashant butola
Mother's Name: saroj butola  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 15 Oct 1998 Name as per passport:
Passport No.: Date of Expiry:
Place of Issue: Nationality: Indian

(Note: If you do not have passport, you may apply for it as early as possible as passport is required for obtaining Seaman’s Discharge Certificate, mandatory for boarding a ship.)

Place of Birth: jammu Personal Identification Mark: left hand burn lightly
Blood Group: AB + Address for Communication: po box karbari shimla by pass dehradun karbari shimla by pass ganashpur
State: Uttaranchal Country: India
Pin: 248007 City/District: Dehradun
Mobile no: 9997144251 Telephone No. with STD code:
Aadhar Card No:373524546444 E-mail: prashantbutola98@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Saroj butola Relationship with candidate: Mother
Parents Date of Birth: 11 Mar 1995 Parent's/Guardian's Occupation/Designation: Teacher
   
Office Address:
   
Address: shimla by pass dehradun ganashpur
Country: India State: Uttaranchal
City/District: Dehradun Pin: 248007
Tel: Mobile no.: 7906048518
Fax: Email: sarojbutola72@gmail.com
 

Education and Academic Record :


Class X: - Diploma: - Mechanical Engineering
Year of Passing: 2015 Year of Joining: 2017
Board: CBSE Year of Passing: 2020
School Name: GRD academy Board: Uttaranchal
City: Dehradun Name of College/Institution: uttranchal university
   
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 50 First year: 60
English: 58 Second year: 68
Address of School/College: patel nagar dehradun Third year: 63
Pin: 248001 Aggregate Percentage: 60
Contact Nos:  
Email: prashantbutola98@gmail.com  
 
Why do you wish to join TMI?: For best placements
What are your hobbies?: Study in silent place
What are your strengths?: sports man
What are your weaknesses?: scared of watching horror movies
How do you intend to meet the expenses of this program?: Bank Loan
 
Declaration

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

Signature of Candidate

 

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Date ________________