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: DNS2171065 Name: Adhil Gafoor P G
  Address: 20/318 Nampiapuram Road Palluruthy Cochin
Telephone No.: Mobile no: 9048217836
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 429008859
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2171065 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: DNS2171065
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Adhil Gafoor P G
Mother's Name: Rahmath Gafoor
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 May 2002 Nationality: Indian
Place of Birth: Kerala Personal Identification Mark: One mile in the nose
Blood Group: A + Address for Communication: 20/318 Nampiapuram Road Palluruthy Cochin
State: Kerala Country: India
Pin: 682006 City/District: Palluruthy Ernakulam
Mobile no: 9048217836 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Gafoor P M Relationship with candidate: Father
Parents Date of Birth: 01 Jun 1971 Parent's/Guardian's Occupation/Designation: Welding
Office Address:
Address: Alappat Enterprises Alappat Brothers building Mahakavi G Road karikkamuri
Country: India State: Kerala
City/District: Ernakulam Pin: 682006
Tel: Mobile no.: 9746188022
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Kerala Board: Kerala
School: St.Dominics English Medium High School School: Edward Memorial Gov Higher Secondary School
City: Ernakulam City: Ernakulam
English %: 96 Board Roll No./Seat No.: 7145081
Aggregate Percentage: 98 School/College Code: 07020
  Centre code: 07020
  Address of School/College: Fort veli Fort Cochin Ernakulam
  Pin: 682001
  Contact Nos:
  Aggregate Percentage: 76
Details of Marks Secured in (10+2) Examination -

Physics 200 112 56
Chemistry 200 120 60
Mathematics 200 96 48
Physics, Chemistry & Mathematics combined Percentage: 54.67
English 100 82 82
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
02/2019 Badminton Club Tournament 5th runner up
How do you intend spending your time after completing class XII Final exams and before joining college ?: I would spend my time in knowing about life at sea.
Why do you wish to join TMI?: I wish to join TMI because it is well known for those who seeks to join merchant navy. And also it has a great value for education
What are your hobbies?: My hobbies are playing badminton and working out.
What are your strengths?: My strength is that I can understand practical knowledge very fast and I am also a fast learner
What are your weaknesses?: My weakness is I became very upset if I make someone feel bad.
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 ________________

Print Summary and Application Form