Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science 2020)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2050637 Name: KENNETH JOHN CAEIRO
  Address: H. NO - 389 B, CAEIRO - NAGAR, BUTICAS II NAVELIM , SALCETE, GOA
Telephone No.: 00919011070570 Mobile no: 9011070570
E-mail: kim1461caeiro@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 306649421
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050637 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
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2020

 
  Dossier ID: DNS2050637
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: KENNETH JOHN CAEIRO
Mother's Name: REENA VAZ
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 21 Sep 2002 Nationality: INDIAN
Place of Birth: GOA Personal Identification Mark: MOLE BEHIND LEFT KNEE
Blood Group: O + Address for Communication: H. NO - 389 B, CAEIRO - NAGAR, BUTICAS II NAVELIM , SALCETE, GOA
State: Goa Country: India
Pin: 403707 City/District: SOUTH GOA
Mobile no: 9011070570 Telephone No. with STD code: 00919011070570
Aadhar Card No:673826273719 E-mail: kim1461caeiro@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: MACS CAEIRO Relationship with candidate: FATHER
Parents Date of Birth: 06 Feb 1968 Parent's/Guardian's Occupation/Designation: PRIVATE SERVICE
   
Office Address:
   
Address: H. NO - 389 B, CAEIRO - NAGAR, BUTICAS II NAVELIM, SALCETE, GOA
Country: India State: Goa
City/District: SOUTH GOA Pin: 403707
Tel: 9011070570 Mobile no.: 8600096880
Fax: Email: macscaeiro2003@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Goa Board: Goa
School: LOYOLA HIGH SCHOOL School: LOYOLA HIGHER SECONDARY SCHOOL
City: MARGAO City: MARGAO
English %: 74 Board Roll No./Seat No.:
Aggregate Percentage: 83 School/College Code:
  Centre code:
  Address of School/College: COMBA, MARGAO, GOA
  Pin: 403601
  Contact Nos: 08322731474
  Email: loyolahss.2014@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
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
09/2019 FOOTBALL INTER COLLEGE GOAL KEEPER
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
04/2010 BASICS IN COMPUTER One month
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Computer course continue
Why do you wish to join TMI?: Top ranking college for Marine studies.
What are your hobbies?: football, cricket, reading, travelling
What are your strengths?: good listener, decision making, communication skill, hard working, confident and daring personality
What are your weaknesses?: cooking
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded 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

 

___________________

Date ________________

 
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