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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) 2020
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| Application Summary: Lateral Entry - B.Tech (Marine Engineering) |
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| Dossier ID: LTE2054981 |
Name: FERNANDES JOSTON SEBASTIAN |
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Address: SS1, ROOM NO.- 80 ,SECTOR 1, KOPARKHAIRANE NAVI MUMBAI |
| Telephone No.: |
Mobile no: 9137402719 |
| E-mail: jostonernandes@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 1200 (Includes Convenience fee of ₹ ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 316669553 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID LTE2054981 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 Lateral Entry - Marine Engineering, Dossier ID on the envelope
- Printout of application form along with summary page duly filled and signed wherever indicated
- Three identical recent passport size photographs with name & dossier id written at the back
- Self – attested copies of Class X mark sheet and Pass Certificate
- Self – attested copies of all semester mark sheets and final mark sheet / certificate
- Self – attested copies of school/college leaving certificate / transfer certificate
- Letter from college mentioning AICTE approval number of the course and college
- Copy of Caste Certificate (If any)
- Copy of Migration Certificate
- Copies of sports and extra-curricular activities (Class VIII and above only)
- A non-refundable Demand Draft of Rs. 1200/- 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 Lateral Entry - B.Tech (Marine Engineering)
Tolani Maritime Institute
Talegaon-Chakan road, Induri,
Talegaon, Pune, Pin- 410507
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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: FERNANDES JOSTON SEBASTIAN |
| Mother's Name: JOSPHINE FERNANDES |
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| Marital Status (Single/Married): Single |
Gender (M/F): Male |
| Date of Birth (DD/MM/YY): 15 Jan 2001 |
Name as per passport:JOSTON JERALD FERNANDES |
| Passport No.: T7979788 |
Date of Expiry: 28 Aug 2029 |
| Place of Issue: MUMBAI |
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: VASHI |
Personal Identification Mark: SMALL MOLE ON RIGHT THIGH |
| Blood Group: B + |
Address for Communication: SS1, ROOM NO.- 80 ,SECTOR 1, KOPARKHAIRANE NAVI MUMBAI |
| State: Maharashtra |
Country: India |
| Pin: 400709 |
City/District: THANE |
| Mobile no: 9137402719 |
Telephone No. with STD code: |
| Aadhar Card No:853346406940 |
E-mail: jostonernandes@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: JERALD FERNANDES |
Relationship with candidate: FATHER |
| Parents Date of Birth: 23 Dec 1958 |
Parent's/Guardian's Occupation/Designation: TAILOR |
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| Office Address: |
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| Address: E2 SHOP NO.4 SECTOR 4 VASHI NAVI MUMBAI |
| Country: India |
State: Maharashtra |
| City/District: THANE |
Pin: 400703 |
| Tel: |
Mobile no.: 9820959315 |
| Fax: |
Email: fernandes.joyrin1997@gmail.com |
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Education and Academic Record :
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| Class X: - |
Diploma: - Mechanical Engineering |
| Year of Passing: 2017 |
Year of Joining: 2017 |
| Board: Maharashtra |
Year of Passing: 2020 |
| School Name: SACRED HEART HIGH SCHOOL |
Board: Maharashtra |
| City: NAVI MUMBAI |
Name of College/Institution: AGNEL POLYTECHNIC |
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| Percentage of Marks Secured: |
Details of Marks Secured: (in percentage) |
| Aggregate: 58 |
First year: 72 |
| English: 54 |
Second year: 62 |
| Address of School/College: Sector 4, Vashi, Mumbai, Maharashtra 400703
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Third year: |
| Pin: 400703 |
Aggregate Percentage: |
| Contact Nos: 02227824704 |
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| Email: sacredheartvashi1982@gmail.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 |
| 09/2019 |
TECHNOCRATZ QUIZ COMPETATION |
STATE LEVEL |
SECOND PLACE |
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| Vocational and Training Courses undertaken: |
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| MONTH / YEAR (MM/YYYY) |
COURSE |
COURSE DURATION |
| 05/2019 |
MANUFACTURING DEPARTMENT |
1MONTH 11DAYS |
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| Why do you wish to join TMI?: BECAUSE I WOULD LIKE TO DEVELOP AND WORK ON MY SKILLS. |
| What are your hobbies?: BASKETBALL |
| What are your strengths?: STRAIGHT FORWARD |
| What are your weaknesses?: STAGE FEAR |
| 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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