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: LTE2061289
 
Applicant's Personal Information:
 
Full Name as on Diploma Marksheet/Pass Certificate: Krishna Kumar Mishra
Mother's Name: Sushma Mishra  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 01 Jan 1970 Name as per passport:Krishna Kumar Mishra
Passport No.: T2560595 Date of Expiry:
Place of Issue: Lucknow 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: Allahabad Personal Identification Mark: Mole on neck
Blood Group: AB + Address for Communication: EA234 ADA colony naini Allahabad Uttar Pradesh Villa anthiya khain, khain karchana Allahabad Uttar Pradesh
State: Uttar Pradesh Country: India
Pin: 211008 City/District: Allahabad
Mobile no: 8218510725 Telephone No. with STD code: 8218510725
Aadhar Card No:222192366834 E-mail: mishraanupam255@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Anil Kumar Mishra Relationship with candidate: Father
Parents Date of Birth: Parent's/Guardian's Occupation/Designation: Government service
   
Office Address:
   
Address: EA234 ADA colony naini Allahabad Uttar Pradesh Villa anthiya khain, khain karchana Allahabad Uttar Pradesh
Country: India State: Uttar Pradesh
City/District: Allahabad Pin: 211008
Tel: Mobile no.: 7080136352
Fax: Email: mishraanupam255@gmail.com
 

Education and Academic Record :
Class X: - Diploma: - Mechanical Engineering
Year of Passing: 2014 Year of Joining: 2015
Board: CBSE Year of Passing: 2018
School Name: ST MARY CONVENT SCHOOL GHOORPUR ALLAHABAD UTTAR PRADESH Board: Uttar Pradesh
City: Allahabad Name of College/Institution: KITE GROUP OF INSTITUTIONS
   
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 76 First year: 77
English: 76 Second year: 76
Address of School/College: EA234 ADA colony naini Allahabad Uttar Pradesh Third year: 80
Pin: 211008 Aggregate Percentage: 78
Contact Nos: 8218510725  
Email: mishraanupam255@gmail.com  
 
Why do you wish to join TMI?: Getting best of Marine Life
What are your hobbies?: Drawing, painting
What are your strengths?: Self confidence
What are your weaknesses?: Planning
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan,Other - Education loan
 
Declaration

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

Signature of Candidate
 

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Date ________________