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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)
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| Application Summary: Diploma in Nautical Science |
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| Dossier ID: DNS2050760 |
Name: NANDHAGOPAL K MANOJ |
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Address: Kaippananickal House Ezhacherry P. O Ezhacherry |
| Telephone No.: |
Mobile no: 9048859151 |
| E-mail: nandhagopalkmanoj@gmail.com |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 200 (Includes Convenience fee of ₹ ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 306938689 |
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| 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 |
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___________________ |
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| Date ________________ |
Date ________________ |
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| 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. |
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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
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| Applicant's Personal Information: |
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| 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: nandhagopalkmanoj@gmail.com |
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| Guardian's Particulars: |
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| 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 |
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| Office Address: |
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| Address: Xpress tours and travels Highcourt junction Ernakulam |
| Country: India |
State: Kerala |
| City/District: Ernakulam |
Pin: 682031 |
| Tel: |
Mobile no.: 9946021832 |
| Fax: |
Email: manojramankr@gmail.com |
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Education and Academic Record :
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| 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 |
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Centre code: 05075 |
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Address of School/College: St Augustines HSS
Ramapuram bazar P. O
Ramapuram |
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Pin: 686576 |
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Contact Nos: |
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Email: ramapuramstaugustineshss@gmail.com |
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Aggregate Percentage: 84 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| 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 |
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| IMU CET Application Number: |
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| Sports & Extra Curricular Activities: |
| Achievements in Sports and Extra Curricular Activities |
| MONTH / YEAR (MM/YYYY) |
SPORT/ACTIVITY |
LEVEL OF PARTICIPATION |
POSITION |
| 09/2015 |
NCC |
School Level |
CDT |
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| 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..
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| 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.
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| 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 |
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| Review you documents: |
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Birth certificate
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DGS Approved Medical Fitness Certificate not uploaded
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Class X marksheet
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School leaving certificate not uploaded
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Class XII admit card not uploaded
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Class XII marksheet
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| 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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