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Vishwakarma Maritime Institute: Admission Form

The document is an admission form for a diploma in nautical science program at Vishwakarma Maritime Institute. It requests personal details from applicants such as name, address, qualifications, and references. It outlines the application process and requirements including a registration fee and documents needed. Sponsorship options are also mentioned.

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Arun
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41 views

Vishwakarma Maritime Institute: Admission Form

The document is an admission form for a diploma in nautical science program at Vishwakarma Maritime Institute. It requests personal details from applicants such as name, address, qualifications, and references. It outlines the application process and requirements including a registration fee and documents needed. Sponsorship options are also mentioned.

Uploaded by

Arun
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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VISHWAKARMA MARITIME INSTITUTE (INDoS No- 87)

CRISIL Grade - Very Good & ISO 9001:2008 Certified

Application
Number

Sr.No.2,Kondhwa Bk.,Pune411048.Tel.91-20-64785715/16 Fax: 91-20-26932700

VMI/FF-24A
01/07/2015
Rev.No.0 Iss.No.1

E-mail info@vmipune.com, Web site - www.vmipune.com.

ADMISSION FORM
DIPLOMA IN NAUTICAL SCIENCE (1 YR) LEADING TO B.SC. (NAUTICAL SCIENCE)
PLEASE COMPLETE IN BLOCK LETTERS
Personal Details:
FULL NAME (in capitals): (As given in the records of Board / University)

Affix recent
passport size
photograp
h
here (Taken
within six
months)

(Last Name)

(First Name)

(Middle Name)

(Last Name)
Occupation (in full detail):

(First Name)

(Middle Name)

Father's Name:

Now stationed at:

Address for Correspondence:

Pin code:

State:

Tel No. (With STD Code)


Email ID:

Address of next of kin or Guardian (with relationship to contact in case of emergency)

Pin code:

State:

Tel No. (With STD Code):

Email ID:

Date of Birth

Nationality

Place of Birth
Passport No.
Place of Issue
Marital Status

Sex
(if available)

Male / Female

Date of Issue
Date of Expiry
Height

cms Weight

Kgs

Qualifications :

Name of School -where you completed X Std. & passing year:-

Name of School/College -where you completed XII Std & passing year:-

Name of College and Board/University from where you obtained your B.Sc. with PCM group & passing year: Subject

% Obtained

English
IMU Entrance test Appeared

Std X

Std XII

Std XII (Agree)

Yes

No

Date Appeared:

Category

Std XII (PCM)

B.SC. / B.Tech (Agree)


(If applicable)

Rank:

Encl. attested photocopies of documents


1. 10
2. 10
3. 12
4. 12

th
th
th
th

Mark Sheet

5. Birth date Certificate

Certificate

6. B.Sc. Mark sheet

Mark Sheet

7. B.Sc. / B.Tech Certificate

Certificate

8. Passport (If any)

Further Information:
Please give any further appropriate information to support your application e.g. Achievements, Extra
Curricular Activities, hobbies, special interests, etc.
I hereby declare that I have read and understood the conditions of eligibility
for the course to which I seek admission. I fulfill the minimum eligibility criteria and I have provided necessary
information in this regard. In the event of any information being found incorrect or misleading my candidature
shall be liable to cancellation at any time and I shall not be entitled to refund of any fee paid by me to the
academy. The original certificates will be produced at the time of Interview.
Registration Fee of Rs.1500/- by Cash/Demand Draft No. ___________________ dated ________________ drawn in
favour of Vishwakarma Maritime Institute Payable at Pune.

Applicants Signature

Date

APPLICATION RECEIVED ON :
INTERVIEWED ON
RESULTS OF INTERVIEW
MEDICAL EXAMINATION
SELECTED TO JOIN

PASSED

FAILED

PASSED

FAILED

YES

NO

DIRECTOR

2IMU - Shanti Consultancy

INSTRUCTION FOR SPONSORSHIP APPLICATION : Need Help 09304612791

Complete all the available details required and attached the DEMAND DRAFT of
Rs 1500 (Application Processing Fee) drawn in favor of
Vishwakarma Maritime Institute Payable at Pune.
Get VMI Sponsorship Test Preparation support By Shanti Consultancy
Absolutely Free Just mail your filled application form to
vmisponsorship@gmail.com
For offline Application : E-Mail scan of filled application to
vmisponsorship@gmail.com OR
For Online Application: E-Mail Payment Receipt Confirmation to
vmisponsorship@gmail.com To get preparatory materials free.
Also For offline Application, Hard copy of filled application along with
Demand Draft should be sent Via fastest Courier to :
Mr. Mahesh More ( Admission Incharge)
VISHWAKARMA MARITIME INSTITUTE
SURVEY NO.2, LAXMI NAGAR,
KONDHWA ( BUDRUK),
PUNE- 411048

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