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:
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: YOGA KEERTHIGAN Y
Mother's Name: EZHILARASI
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 24 Jul 1999 Nationality: INDIAN
Place of Birth: CHENNAI Personal Identification Mark: MOLE ON RIGHT ARMS
Blood Group: O + Address for Communication: NO 5 2ND CROSS STREET KATTUKUPPAM ENNORE
State: Tamil Nadu Country: India
Pin: 600057 City/District: CHENNAI
Mobile no: 9884035954 Telephone No. with STD code: 9884035954
Aadhar Card No:835536701254 E-mail: yoga247820@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: JEYA PRAKESH Relationship with candidate: UNCLE
Parents Date of Birth: 07 Mar 1976 Parent's/Guardian's Occupation/Designation: CHIEF COOK
   
Office Address:
   
Address: 22 RAJA MUTHUIAH SALAI COOLAI
Country: India State: Tamil Nadu
City/District: CHENNAI Pin: 600003
Tel: Mobile no.: 9840226095
Fax: Email: jk.keertana@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: Year of Passing:
Board: Board:
School: School:
City: City:
English %: Board Roll No./Seat No.:
Aggregate Percentage: School/College Code:
  Centre code:
  Address of School/College:
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Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
Physics, Chemistry & Mathematics combined Percentage:
English
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
 
Review you documents:
Birth certificate not uploaded DGS Approved Medical Fitness Certificate not uploaded Class X marksheet not uploaded School leaving certificate not uploaded Class XII admit card not uploaded 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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