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.Tech. Marine Engineering Course Enrolled (Second Choice): B.Sc. Nautical Science
Dossier ID: DEG2184176 Name: ABDUL SAMAD JAMAL
  Address: MULAKKAMPILLY HOUSE KUNNUMPURAM THRIKKAKARA COCHIN-21
Telephone No.: Mobile no: 9567516677
E-mail: abdulsamadjamalmulakkampilly@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1212.73 (Includes Convenience fee of ₹ 12.73 ) DD Number: -
Issuing Bank: - Transaction Id: 435362406
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DEG2184176 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.Tech. Marine Engineering Course: Second Choice B.Sc. Nautical Science
Dossier ID: DEG2184176
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: ABDUL SAMAD JAMAL
Mother's Name: AISHA JAMAL
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Jul 2003 Nationality: INDIAN
Place of Birth: Ernakulam Personal Identification Mark: BLACK MARK ON LEFT HAND
Blood Group: O +  
 
Date of Birth (DD/MM/YY): 01 Jul 2003 Nationality: INDIAN
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: MULAKKAMPILLY HOUSE KUNNUMPURAM THRIKKAKARA COCHIN-21
State: Kerala Country: India
Pin: 682021 City/District: Ernakulam
Mobile no: 9567516677 Telephone No. with STD code:
Aadhar Card No:886913740847 E-mail: abdulsamadjamalmulakkampilly@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: JAMAL MK Relationship with candidate: FATHER
Parents Date of Birth: 15 Jan 1970 Parent's/Guardian's Occupation/Designation: BUSINESS
   
Office Address:
   
Address: MULAKKAMPILLY HOUSE KUNNUMPURAM THRIKKAKARA COCHIN-21
Country: India State: Kerala
City/District: Ernakulam Pin: 682021
Tel: 09895852379 Mobile no.: 9895852379
Fax: Email: jamalmk33@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Kerala
School: COCHIN PUBLIC SCHOOL School: MARY MATHA HSS
City: Ernakulam City: ERNAKULAM
English %: 87 Board Roll No./Seat No.:
Aggregate Percentage: 79 School/College Code:
  Address of School/College: VAZHAKKAL ,THOPPIL ROAD ,THRIKKAKARA P.O
  Centre code:
  Pin: 682021
  Contact Nos: 9995347314
  Email: marymathahss@yahoo.co.in
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 200
Chemistry 200
Mathematics 200
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
04/2018 volley ball cochin refinery setter
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: PREPARE FOR ENTRANCE EXAMS
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: NOT JUST STUDY, ITS MY DREAM
Why do you wish to join TMI?: TRUST IS THE KEY FACTOR
What are your hobbies?: SWIMMING AND VOLLEY BALL
What are your strengths?: STRAIGHT FORWARD
What are your weaknesses?: ALWATS WATCH VIDEOS OF INSIDE SHIP. MY MOM ALWAYS USED TO TEASE ME FOR SPENDING MUCH TIME INFRONT OF LAPTOP.
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 not uploaded
 
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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