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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: Roshan Tiwari |
Mother's Name: Sunita tiwari |
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Marital Status (Single/Married): Single |
Gender (M/F): Male |
Date of Birth (DD/MM/YY): 22 Dec 1997 |
Name as per passport: |
Passport No.: |
Date of Expiry: |
Place of Issue: |
Nationality: |
(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: Ballia |
Personal Identification Mark: Mole on right hand between thumb and index finger |
Blood Group: B + |
Address for Communication: Zirabasti Zirabasti Zirabasti |
State: Uttar Pradesh |
Country: India |
Pin: 277001 |
City/District: Ballia |
Mobile no: 7844934964 |
Telephone No. with STD code: |
Aadhar Card No: |
E-mail: roshantiwarir0m@gmail.com |
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Guardian's Particulars: |
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Name of Parent/Guardian: Om Prakash Tiwari |
Relationship with candidate: Father |
Parents Date of Birth: 19 Oct 1973 |
Parent's/Guardian's Occupation/Designation: Defence |
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Office Address: |
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Address: Aizwal Aizawl crpf |
Country: India |
State: Mizoram |
City/District: Aizwal |
Pin: 277001 |
Tel: |
Mobile no.: 9621143945 |
Fax: |
Email: roshantiwarir0m@gmail.com |
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Education and Academic Record :
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Class X: - |
Diploma: - Mechanical Engineering |
Year of Passing: 2012 |
Year of Joining: 2015 |
Board: CBSE |
Year of Passing: 2018 |
School Name: St Xavier school |
Board: Uttar Pradesh |
City: Ballia |
Name of College/Institution: Town polytechnic Ballia |
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Percentage of Marks Secured: |
Details of Marks Secured: (in percentage) |
Aggregate: 81 |
First year: 69 |
English: 85 |
Second year: 67 |
Address of School/College: Dharahara Ballia Uttar Pradesh |
Third year: 79 |
Pin: 277001 |
Aggregate Percentage: 79 |
Contact Nos: |
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Email: st.xavierschoolballia@gmail.com |
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Why do you wish to join TMI?: I have seen review of different people who passed out from tmi.
So i think tmi gives me a platform to skill out my potential . |
What are your hobbies?: Debate on particular topics. |
What are your strengths?: I have patience. |
What are your weaknesses?: Expectations. |
How do you intend to meet the expenses of this program?: 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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