Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science 2021)

Application Summary: Diploma in Nautical Science
Dossier ID: DNS2170848 Name: Kannuri Jagadeesh
Telephone No.: Mobile no: 9908264770
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 424663647
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2170848 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: DNS2170848
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Kannuri Jagadeesh
Mother's Name: Kannuri varalakshmi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Jan 2002 Nationality: Indian
Place of Birth: VISAKHAPATA Personal Identification Mark: A mole on the right fore arm
Blood Group: O + Address for Communication: BAPUJINAGAR, RYTHUBAZAR DOWN GOPALAPATNAM
State: Andhra Pradesh Country: India
Pin: 530027 City/District: VISAKHAPATANAM
Mobile no: 9908264770 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Kannuri varalakshmi Relationship with candidate: Mother
Parents Date of Birth: 01 Jan 1983 Parent's/Guardian's Occupation/Designation: Sales man
Office Address:
Address: Dabagardens Visakhapatnam
Country: India State: Andhra Pradesh
City/District: VISAKHAPATANAM Pin: 530027
Tel: Mobile no.: 9908264770
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Andhra Pradesh Board: Andhra Pradesh
School: Mahathi model school School: SRI CHAITANYA JUNIOR COLLEGE
English %: 100 Board Roll No./Seat No.: 2002231818
Aggregate Percentage: 100 School/College Code: 02118
  Centre code: ALDS
  Address of School/College: NAD X ROAD, VISAKHAPATNAM
  Pin: 530048
  Contact Nos:
  Aggregate Percentage: 74
Details of Marks Secured in (10+2) Examination -

Physics 150 106 70.67
Chemistry 150 90 60
Mathematics 300 182 60.67
Physics, Chemistry & Mathematics combined Percentage: 63.78
English 100 84 84
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
12/2017 CHESS Teachers WINNER
04/2021 KABBADI Teachers WINNERS
How do you intend spending your time after completing class XII Final exams and before joining college ?: I spent my time by reading books, having time with my parents and relatives and drawing some interesting pictures. I also used to help my colony people in distributing food and masks to the road side people.
Why do you wish to join TMI?: Everyone wishes to join in the top most college and secure their future and TMI is one of the best college in that
What are your hobbies?: reading about interesting topics, drawing, swimming
What are your strengths?: Self confidence, Self motivation, Quick learner
What are your weaknesses?: being polite to all
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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