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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: DNS2051846 |
Name: CHAKOCHAN VELADY |
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Address: CHAKOCHAN VELADY, VELANMARUKUDIYIL, BHARANANGANAM PALA |
| Telephone No.: |
Mobile no: 9740155477 |
| E-mail: SANDHYASANJAYJAMES@GMAIL.COM |
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| Application fee payment details: |
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| Payment Status: Paid |
Payment Mode: Online |
| Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) |
DD Number: - |
| Issuing Bank: - |
Transaction Id: 309701673 |
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| Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051846 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: CHAKOCHAN VELADY |
| Mother's Name: BEENA ANTONY |
| Gender (M/F): Male |
Marital Status (Single/Married): Single |
| Date of Birth (DD/MM/YY): 11 Nov 2001 |
Nationality: INDIAN |
| Place of Birth: MUTHLAKODAM |
Personal Identification Mark: A BLACK MOLE ON RIGHT ARM |
| Blood Group: A + |
Address for Communication: CHAKOCHAN VELADY, VELANMARUKUDIYIL, BHARANANGANAM PALA |
| State: Kerala |
Country: India |
| Pin: 686578 |
City/District: KOTTAYAM |
| Mobile no: 9740155477 |
Telephone No. with STD code: |
| Aadhar Card No: |
E-mail: SANDHYASANJAYJAMES@GMAIL.COM |
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| Guardian's Particulars: |
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| Name of Parent/Guardian: ANTONY VELADY |
Relationship with candidate: FATHER |
| Parents Date of Birth: 13 Jan 1966 |
Parent's/Guardian's Occupation/Designation: AGRICULTURE |
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| Office Address: |
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| Address: ANTONY VELADY VELANMARUKUDIYIL, BHARANANGANAM PALA |
| Country: India |
State: Kerala |
| City/District: KOTTAYAM |
Pin: 686578 |
| Tel: |
Mobile no.: 9745081207 |
| Fax: |
Email: VELADY360@GMAIL.COM |
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Education and Academic Record :
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| Class X: - |
Class XII: - |
| Year of Passing: 2018 |
Year of Passing: 2020 |
| Board: Kerala |
Board: Kerala |
| School: KTJM HS EDAMATTOM |
School: ST MARYS HSS BHARANANGANAM |
| City: PALA |
City: PALA |
| English %: 100 |
Board Roll No./Seat No.: 7114278 |
| Aggregate Percentage: 100 |
School/College Code: 05043 |
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Centre code: 05043 |
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Address of School/College: ST MARYS HSS BHARANANGANAM
BHARANANGANAM
KOTTAYAM DIST
KERALA |
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Pin: 686578 |
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Contact Nos: |
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Email: VELADY360@GMAIL.COM |
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Aggregate Percentage: 76 |
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| Details of Marks Secured in (10+2) Examination - |
| SUBJECTS |
MAXIMUM MARKS
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MARKS SECURED |
PERCENTAGE (%) |
| Physics |
200 |
142 |
71 |
| Chemistry |
200 |
149 |
74.5 |
| Mathematics |
200 |
118 |
59 |
| Physics, Chemistry & Mathematics combined Percentage: |
68.17 |
| English |
100 |
76 |
76 |
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| IMU CET Application Number: CET20U99611 |
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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 |
| 08/2018 |
CRICKET |
DISTRICT |
SECOND |
| 08/2018 |
KABADI |
DISTRICT |
NONE |
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| How do you intend spending your time after completing class XII Final exams and before joining college ?: READING BOOKS, SURFING NET, ACTIVE PARTICIPATION IN SPORTS, SWIMMING AND PREPRATION FOR CET EXAM. |
| Why do you wish to join TMI?: BECAUSE IT IS ONE OF THE FAMOUS COLLEGE IN INDIA |
| What are your hobbies?: CRICKET, READING , TRAVELLING, SWIMMMING |
| What are your strengths?: I believe that my greatest strength in life is my determination to strive hard in order to fulfill my dreams and my family. |
| What are your weaknesses?: My greatest weakness is that I am afraid to fail. But as I fail, I learn from my mistakes. Friends and cricket are also my weakness |
| 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 not uploaded
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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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