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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: LTE2060897 |
Name: SHUBHAM KUMAR |
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Address: RAMESHWARAM COLONY NEAR ANADI APPARTMENT BARIATU ROAD RANCHI |
| Telephone No.: |
Mobile no: 8789859372 |
| E-mail: shubhamkumarcip@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: 330339498 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID LTE2060897 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: SHUBHAM KUMAR |
| Mother's Name: BABY DEVI |
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| Marital Status (Single/Married): Single |
Gender (M/F): Male |
| Date of Birth (DD/MM/YY): 02 Oct 2000 |
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: RANCHI |
Personal Identification Mark: MOLE MARK AT CENTER OF CHEST |
| Blood Group: O + |
Address for Communication: RAMESHWARAM COLONY NEAR ANADI APPARTMENT BARIATU ROAD RANCHI |
| State: Jharkhand |
Country: India |
| Pin: 834009 |
City/District: RANCHI |
| Mobile no: 8789859372 |
Telephone No. with STD code: |
| Aadhar Card No:263633138862 |
E-mail: shubhamkumarcip@gmail.com |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: DEEPAK KUMAR SINGH |
Relationship with candidate: FATHER |
| Parents Date of Birth: 11 Apr 1968 |
Parent's/Guardian's Occupation/Designation: SUPERVISOR |
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| Office Address: |
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| Address: SHIVALIK HIGHT RAMESHWARAM COLONY BARIATU ROAD RANCHI |
| Country: India |
State: Jharkhand |
| City/District: RANCHI |
Pin: 834009 |
| Tel: |
Mobile no.: 6299913273 |
| Fax: |
Email: bksunny014@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: Jharkand |
Year of Passing: 2020 |
| School Name: ST JOHNS HIGH SCHOOL |
Board: Jharkand |
| City: RANCHI |
Name of College/Institution: CAMBRIDGE INSTITUTE OF POLYTECHNIC |
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| Percentage of Marks Secured: |
Details of Marks Secured: (in percentage) |
| Aggregate: 70 |
First year: 72 |
| English: 66 |
Second year: 65 |
| Address of School/College: KARBALA TANK ROAD RANCHI |
Third year: |
| Pin: 834001 |
Aggregate Percentage: |
| Contact Nos: |
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| Email: principalsjcran@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 |
| 07/2016 |
DISTRICT UNDER 16 CRICKET |
DISTRICT LEVEL |
RUNNER UP |
| 06/2015 |
PARTICIPATED IN INTERNATIONAL YOGA DAY |
STATE LEVEL |
AS A PARTICIPANT |
| 05/2012 |
QUIZ COMPETITION |
DISTRICT LEVEL |
GOLD MEDAL |
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| Why do you wish to join TMI?: BECAUSE TMI HAVE A VERY GOOD FACULTY MEMBERS |
| What are your hobbies?: PLAYING CRICKET AND WATCHING TV |
| What are your strengths?: I AM SELF MOTIVATED AND PUNCTUAL IN TIME AND ALSO FULL OF CREATIVE ENERGY |
| What are your weaknesses?: LACK OF CONFIDENCE |
| 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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