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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
Lateral Entry - B.Tech (Marine Engineering)
APPLICATION FOR ADMISSION - 2020
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Applicant's Personal Information: |
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Full Name as on Diploma Marksheet/Pass Certificate: Amar Nath Hazam |
Mother's Name: Gangotri devi |
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Marital Status (Single/Married): Single |
Gender (M/F): Male |
Date of Birth (DD/MM/YY): 26 Nov 1997 |
Name as per passport:Amar Nath Hazam |
Passport No.: T9124817 |
Date of Expiry: |
Place of Issue: India |
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: Ranchi |
Personal Identification Mark: Cut mark on forehead |
Blood Group: B + |
Address for Communication: C/O DR.KUSUM PRASAD,NEAR FIRING RANGE, BARIATU Ranchi |
State: Jharkhand |
Country: India |
Pin: 834009 |
City/District: RANCHI |
Mobile no: 8340582694 |
Telephone No. with STD code: |
Aadhar Card No:231598537954 |
E-mail: amarnathhazam797@gmail.com |
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Guardian's Particulars: |
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Name of Parent/Guardian: Krishna Hazam |
Relationship with candidate: Father |
Parents Date of Birth: 03 Jan 1964 |
Parent's/Guardian's Occupation/Designation: Business |
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Office Address: |
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Address: C/O DR.KUSUM PRASAD,NEAR FIRING RANGE, OPPOSITE TO BHAGAT Motors,Bariatu |
Country: India |
State: Jharkhand |
City/District: RANCHI |
Pin: 834009 |
Tel: |
Mobile no.: 9835375054 |
Fax: |
Email: amarnathhazam797@gmail.com |
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Education and Academic Record :
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Class X: - |
Diploma: - Mechanical Engineering |
Year of Passing: 2014 |
Year of Joining: 2017 |
Board: CBSE |
Year of Passing: 2020 |
School Name: DAV PUBLIC SCHOOL BARIATU |
Board: West Bengal |
City: RANCHI |
Name of College/Institution: Amar Nath Hazam |
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Percentage of Marks Secured: |
Details of Marks Secured: (in percentage) |
Aggregate: 66 |
First year: 71 |
English: 66 |
Second year: 68 |
Address of School/College: DAV Campus, Opp Housing Colony, Bariatu RD, Bariatu, Ranchi, Jharkhand 834009 |
Third year: |
Pin: 834009 |
Aggregate Percentage: |
Contact Nos: 06512541191 |
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Email: dav_bariatu@yahoo.com |
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Sports & Extra Curricular Activities: |
Achievements in Sports and Extra Curricular Activities |
MONTH / YEAR (MM/YYYY) |
SPORT/ACTIVITY |
LEVEL OF PARTICIPATION |
POSITION |
09/2015 |
Basketball |
Icse zonal level basketball tournament |
Second |
04/2018 |
Make best out of waste |
Tech craze 2k18 skfgi tech fest |
First |
09/2018 |
Ramp walk |
Refresko 2k18 Ramp walk competition |
First |
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Why do you wish to join TMI?: Marine engineering is considered one of the toughest field where your mental toughness as well as your physical ability is tested. At present this is the best maritime academy in india with the maximum training knowledge and placement percentage. As i see my needs will be definitely fulfilled by your University so my goal as well |
What are your hobbies?: Playing outdoor sports, Traveling, Cooking, Make best out of waste,hinking, music, sketching, gardening, etc |
What are your strengths?: Team player, Time management abilities, ability to perform under pressure, disciplined, creativity, respectfulness, honesty |
What are your weaknesses?: Insecure, self criticism, take on too much responsibility |
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan |
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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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