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


  Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: YADUKRISHNA S
Mother's Name: Manju k k
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Mar 2004 Nationality: Indian
Place of Birth: Ponkunnam Personal Identification Mark: A mole on middle head
Blood Group: B + Address for Communication: Karinattu house kochera p.o chettukuzhy ,idukki ,685551 karrinattu house kochera p .o chettukuzhy,idukki,685551
State: Kerala Country: India
Pin: 685551 City/District: Kattaapaaana
Mobile no: 7306071912 Telephone No. with STD code:
Aadhar Card No:721665775998 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: SIVAPRASAD K K Relationship with candidate: FATHER
Parents Date of Birth: 20 Feb 1972 Parent's/Guardian's Occupation/Designation: GOVERNMENT STAFF
Office Address:
Address: karrinattu house kochera p.o chettukuzhy karrinattu house kochera p.o chettukuzhy
Country: India State: Kerala
City/District: idukki Pin: 685551
Tel: Mobile no.: 9496062259
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Kerala Board: Kerala
School: hss kattappana School: hss kattappana
City: kattappana City: Kattappana
English %: 90 Board Roll No./Seat No.:
Aggregate Percentage: 95 School/College Code:
  Centre code:
  Address of School/College: St .george hss kattappana ,south p.o kattappana ,685515
  Pin: 685515
  Contact Nos:
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 200
Chemistry 200
Mathematics 200
Physics, Chemistry & Mathematics combined Percentage:
English 100
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

I hereby declare that all the statements made above are true and correct.

Signature of Candidate



Date ________________

Print Summary and Application Form