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 2021)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2172661 Name: PAVAN K REJISH
  Address: Mayamandiram house South Aduvassery po Kunnukara,Ernakulam
Telephone No.: Mobile no: 9446925089
E-mail: pavanmayamandiram@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 432849129
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2172661 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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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: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2021

 
  Dossier ID: DNS2172661
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: PAVAN K REJISH
Mother's Name: Maya M N
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 20 Jan 2004 Nationality: INDIA
Place of Birth: Aluva Personal Identification Mark: A black mole on middle finger of right hand
Blood Group: O + Address for Communication: Mayamandiram house South Aduvassery po Kunnukara,Ernakulam
State: Kerala Country: India
Pin: 683578 City/District: Ernakulam
Mobile no: 9446925089 Telephone No. with STD code:
Aadhar Card No:880205009473 E-mail: pavanmayamandiram@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Rejish K M Relationship with candidate: Father
Parents Date of Birth: 13 May 1972 Parent's/Guardian's Occupation/Designation: Private firm
   
Office Address:
   
Address: Mayamandiram house South Aduvassery po Kunnukara, Ernakulam
Country: India State: Kerala
City/District: Ernakulam Pin: 683578
Tel: Mobile no.: 9447971951
Fax: Email: pavanmayamandiram@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Kerala
School: Sri Sai Vidhya Vihar School: GHSS Chengamanad
City: Aluva City: Aluva
English %: 79 Board Roll No./Seat No.:
Aggregate Percentage: 75 School/College Code:
  Centre code:
  Address of School/College: GHSS Chengamanad
  Pin: 683578
  Contact Nos:
  Email: ghsschengamad@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 200
Chemistry 200
Mathematics 200
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
11/2020 KSEB exam All Kerala School level 1st
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
11/2020 Robotics Training 2 days
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I joined for IMU CET coaching classes and started preparing for IMU CET and sponsorship exams
Why do you wish to join TMI?: Because TMI gives the best placement and best institution
What are your hobbies?: Reading, planting,drawing, hearing music
What are your strengths?: My own confident mind
What are your weaknesses?: Overthinking
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 Class XII marksheet not uploaded
 
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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