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
Application Summary: Lateral Entry - B.Tech (Marine Engineering)
 
Dossier ID: LTE2064714 Name: Gaurab Kumar
  Address: Nandan Pahar Road Gali No 2 Paradise House Deoghar Jharkhand
Telephone No.: Mobile no: 8862848473
E-mail: gaurabsingh74@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1212.73 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 343069838
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID LTE2064714 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

___________________

___________________
   
Date ________________ Date ________________
 

 
Please quote your dossier id and full name for any future correspondence
Please ensure that you send the following documents with your application.
  1. Write Application for Lateral Entry - Marine Engineering, Dossier ID on the envelope
  2. Printout of application form along with summary page duly filled and signed wherever indicated
  3. Three identical recent passport size photographs with name & dossier id written at the back
  4. Self – attested copies of Class X mark sheet and Pass Certificate
  5. Self – attested copies of all semester mark sheets and final mark sheet / certificate
  6. Self – attested copies of school/college leaving certificate / transfer certificate
  7. Letter from college mentioning AICTE approval number of the course and college
  8. Copy of Caste Certificate (If any)
  9. Copy of Migration Certificate
  10. Copies of sports and extra-curricular activities (Class VIII and above only)
  11. 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)
  12. Please keep a copy of the form for your reference for communicating with the Institute
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

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: LTE2064714
 
Applicant's Personal Information:
 
Full Name as on Diploma Marksheet/Pass Certificate: Gaurab Kumar
Mother's Name: Kusum Kumari  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 12 Aug 2000 Name as per passport:Gaurab Kumar
Passport No.: T9125257 Date of Expiry: 13 Nov 2029
Place of Issue: Ranchi 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: Deoghar Personal Identification Mark: Mark of Mole On Left Cheek
Blood Group: O + Address for Communication: Nandan Pahar Road Gali No 2 Paradise House Deoghar Jharkhand
State: Jharkhand Country: India
Pin: 814112 City/District: Deoghar
Mobile no: 8862848473 Telephone No. with STD code:
Aadhar Card No:907581680094 E-mail: gaurabsingh74@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sudhir Kumar Relationship with candidate: Father
Parents Date of Birth: 12 Aug 1970 Parent's/Guardian's Occupation/Designation: Clerk
   
Office Address:
   
Address: Vinoba Bhave University M.E.D Department Hazaribagh
Country: India State: Jharkhand
City/District: Hazaribagh Pin: 825301
Tel: Mobile no.: 6201823199
Fax: Email: sudhirvbu78@gmail.com
 

Education and Academic Record :
Class X: - Diploma: - Mechanical Engineering
Year of Passing: 2015 Year of Joining: 2015
Board: CBSE Year of Passing: 2018
School Name: St Xaviers High School Board: Other
City: Deoghar Name of College/Institution: Birla Institute Of Technology Mesra Ranchi
   
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 95 First year: 70
English: 95 Second year: 65
Address of School/College: St Xaviers High School, Satar Road, Durgapur, Deoghar Jharkhand Third year: 73
Pin: 814112 Aggregate Percentage: 69
Contact Nos: 9199345172  
Email: www.stxaviersdeoghar@gmail.com  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
11/2017 Technical Fest Water Filter 1st Position
11/2017 Tech Fest Debate 2nd Position
10/2015 Technical Fest Smart City Project Consolation Prize
12/2013 Annual Sports Meet 200 Metres Race 2nd Position
 
Why do you wish to join TMI?: I want to be a Marine Engineer
What are your hobbies?: Playing Badminton and Chess
What are your strengths?: I am Honest and Hardworking
What are your weaknesses?: I trust people easily.
How do you intend to meet the expenses of this program?: Bank Loan
 
Declaration

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

Signature of Candidate
 

___________________

Date ________________
 
Print Summary and Application Form