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: DNS2051386 Name: CK Kishore
  Address: Chithiralayam,kidangayam,noorand padanilam PO,Alappuzha
Telephone No.: Mobile no: 9562625114
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 308830007
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051386 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: DNS2051386
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: CK Kishore
Mother's Name: Bindhu MS
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 24 Jul 2000 Nationality: Indian
Place of Birth: pandalam Personal Identification Mark: moul on left cheek
Blood Group: A + Address for Communication: Chithiralayam,kidangayam,noorand padanilam PO,Alappuzha
State: Kerala Country: India
Pin: 690529 City/District: alappuzha
Mobile no: 9562625114 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: karunakaran pillai B Relationship with candidate: father
Parents Date of Birth: 21 May 1968 Parent's/Guardian's Occupation/Designation: business
Office Address:
Address: Chithiralayam,kidangayam,noorand padanilam PO, Alappuzha
Country: India State: Kerala
City/District: alappuzha Pin: 690529
Tel: Mobile no.: 8113888431
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: Kerala
School: cherupushpa bethani school chunnakkara alleppey kerala School: government higher secondary school chunakara
City: alappuzha City: alappuzha
English %: 100 Board Roll No./Seat No.: 6084566
Aggregate Percentage: 96 School/College Code: 04018
  Centre code: 04018
  Address of School/College: ghss chunakkara, mavelikara,alappuzha,kerala
  Pin: 690534
  Contact Nos:
  Aggregate Percentage: 73
Details of Marks Secured in (10+2) Examination -

Physics 200 159 79.5
Chemistry 200 125 62.5
Mathematics 200 104 52
Physics, Chemistry & Mathematics combined Percentage: 64.67
English 100 80 80
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
10/2016 karate championship state 2
11/2016 western style guitar competition school 2
11/2016 light music school 1
How do you intend spending your time after completing class XII Final exams and before joining college ?: Most of the time i used to help my parents in there business. In addition to that ,i used to take karate classes and did some driving jobs to make some money
Why do you wish to join TMI?: My cousin brother done his nautical technology from TMI and he recommended me this college Besides that i always wanted to join well renowned and best college in the field of merchant navy
What are your hobbies?: singing,music,karate,movies,football
What are your strengths?: hardworking,confident,leadership quality,adaptability,quick learner, public speaker
What are your weaknesses?: handwritinf,time management
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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