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

Application Summary: Diploma in Nautical Science
Dossier ID: DNS2050760 Name: NANDHAGOPAL K MANOJ
  Address: Kaippananickal House Ezhacherry P. O Ezhacherry
Telephone No.: Mobile no: 9048859151
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 306938689
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050760 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 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:, Web:
(New Admission Diploma in Nautical Science )


  Dossier ID: DNS2050760
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: NANDHAGOPAL K MANOJ
Mother's Name: Raji K S
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 23 Feb 2001 Nationality: Indian
Place of Birth: Pala Personal Identification Mark: A scar on the chin
Blood Group: B + Address for Communication: Kaippananickal House Ezhacherry P. O Ezhacherry
State: Kerala Country: India
Pin: 686651 City/District: Kottayam
Mobile no: 9048859151 Telephone No. with STD code:
Aadhar Card No:253021987504 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: K R Manoj Relationship with candidate: Father
Parents Date of Birth: 19 Feb 1972 Parent's/Guardian's Occupation/Designation: Driver
Office Address:
Address: Xpress tours and travels Highcourt junction Ernakulam
Country: India State: Kerala
City/District: Ernakulam Pin: 682031
Tel: Mobile no.: 9946021832
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Kerala Board: Kerala
School: St Augustines HSS School: St Augustines HSS
City: Kottayam City: Kottayam
English %: 90 Board Roll No./Seat No.: 6123719
Aggregate Percentage: 90 School/College Code: 05075
  Centre code: 05075
  Address of School/College: St Augustines HSS Ramapuram bazar P. O Ramapuram
  Pin: 686576
  Contact Nos:
  Aggregate Percentage: 84
Details of Marks Secured in (10+2) Examination -

Physics 200 133 66.5
Chemistry 200 179 89.5
Mathematics 200 149 74.5
Physics, Chemistry & Mathematics combined Percentage: 76.83
English 100 87 87
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
09/2015 NCC School Level CDT
How do you intend spending your time after completing class XII Final exams and before joining college ?: I was preparing for the Tolani Institute exam and IMU CET..
Why do you wish to join TMI?: This is the excellent college in India. This college have nice infrastructure , quality teachers, eco friendly campus and excellent placement records. College have their own shipping company too.
What are your hobbies?: Reading, listening music, playing
What are your strengths?: Easily mingle with others and self confidence
What are your weaknesses?: Get upset when I does not complete a work in the given time.
How do you intend to meet the expenses of this program?: Bank Loan
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card not uploaded Class XII marksheet

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

Signature of Candidate



Date ________________

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