Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
Marine Engineering / Nautical Science Degree Programmes
(New Admission B.Tech. Marine Engineering / B.Sc. Nautical Science 2021)


Application Summary:
 
Course Enrolled (First Choice): B.Sc. Nautical Science Course Enrolled (Second Choice): B.Sc. Nautical Science
Dossier ID: DEG2174676 Name: GOUTHAM S NAIR
  Address: kOKKATTU SREELAKAM PERINGALA P O MAVELIKARA kOKKATTU SREELAKAM PERINGALA P O MAVELIKARA
Telephone No.: 04792449030 Mobile no: 8547249030
E-mail: gsn2449030@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425958708
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2174676 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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Date ________________ Date ________________
 

 

Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
Marine Engineering / Nautical Science Degree Programmes
(New Admission B.Tech. Marine Engineering / B.Sc. Nautical Science )

APPLICATION FOR ADMISSION - 2021

 
Course: First Choice B.Sc. Nautical Science Course: Second Choice B.Sc. Nautical Science
Dossier ID: DEG2174676
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: GOUTHAM S NAIR
Mother's Name: Gayathri G
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 17 Sep 2003 Nationality: INDIA
Place of Birth: KERALA Personal Identification Mark: A mark on right eyebrow
Blood Group: A +  
 
Date of Birth (DD/MM/YY): 17 Sep 2003 Nationality: INDIA
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Passport No.:
Date of Expiry: Place of Issue:
(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.)
 
Address for Communication: kOKKATTU SREELAKAM PERINGALA P O MAVELIKARA kOKKATTU SREELAKAM PERINGALA P O MAVELIKARA
State: Kerala Country: India
Pin: 690559 City/District: Alappuzha
Mobile no: 8547249030 Telephone No. with STD code: 04792449030
Aadhar Card No:752408648512 E-mail: gsn2449030@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Sabu K Nair Relationship with candidate: Father
Parents Date of Birth: 25 May 1972 Parent's/Guardian's Occupation/Designation: Merchant Navy
   
Office Address:
   
Address: kOKKATTU SREELAKAM PERINGALA P O MAVELIKARA kOKKATTU SREELAKAM PERINGALA P O MAVELIKARA
Country: India State: Kerala
City/District: Alappuzha Pin: 690559
Tel: 4792449026 Mobile no.: 8547249030
Fax: Email: gsn2449030@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Kerala
School: HOLY MARY CENTER SCHOOL KAKKANAD ALAPPUZHA KL School: KVSHSS
City: Alappuzha City: Alappuzha
English %: 84 Board Roll No./Seat No.: 8095956
Aggregate Percentage: 75 School/College Code: 04070
  Address of School/College: KVSHSS MUTHUKULAM ALAPPUZHA kerala
  Centre code: 04070
  Pin: 690506
  Contact Nos: 04792472005
  Email: kvshss@gmail.com
  Aggregate Percentage: 87
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 200 168 84
Chemistry 200 196 98
Mathematics 200 173 86.5
Physics, Chemistry & Mathematics combined Percentage: 89.5
English 100 71 71
   
IMU CET Application Number: CET21U1000328  
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
07/2019 Bharat Scouts 2years
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: preparing for entrance, sports, bodybuilding, increasing my vocabulary
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: it is way to my dream to become a sailor
Why do you wish to join TMI?: To get a better education and job opportunity
What are your hobbies?: Football, Gardening
What are your strengths?: Have a positive attitude towards life
What are your weaknesses?: Stage fear
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Your passport not uploaded Class X marksheet Leaving / Transfer Certificate / Birth Certificate Class XII admit card Class XII marksheet
 
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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