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


  Dossier ID: DNS2173994
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Fardin VS
Mother's Name: Fousiya sajid
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 18 Sep 2003 Nationality: Islam
Place of Birth: Aluva Personal Identification Mark: Right hand black dot
Blood Group: A + Address for Communication: 20/1114c, Suhara manzil,valiyakath Sasi road,kacheripady,Palluruthy
State: Kerala Country: India
Pin: 682006 City/District: Ernakulam
Mobile no: 9746767126 Telephone No. with STD code: +91 9746767126
Aadhar Card No:963334731543 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Sajid VA Relationship with candidate: Son
Parents Date of Birth: 27 Feb 1976 Parent's/Guardian's Occupation/Designation: Driver
Office Address:
Address: 20/1114c, Suhara manzil,valiyakath Sasi road,kacheripady,Palluruthy
Country: India State: Kerala
City/District: Ernakulam Pin: 682006
Tel: 09746767126 Mobile no.: 9746767126
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Kerala Board: Kerala
School: Auxilium English Medium school kochi School: Santa Cruz higher secondary school
City: Ernakulam City: Ernakulam
English %: 66 Board Roll No./Seat No.:
Aggregate Percentage: 74 School/College Code:
  Centre code:
  Address of School/College: Santa Cruz higher secondary school fortkochi ernakulam
  Pin: 682001
  Contact Nos: 9746767126
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
10/2018 Road cycling State Participated
12/2018 Track cycling State Participated
8/2017 Mountain cycling State Participated
How do you intend spending your time after completing class XII Final exams and before joining college ?: I used to do workouts for my hobbies
Why do you wish to join TMI?: For diploma in nautical science.
What are your hobbies?: Athletics ,cycling
What are your strengths?: My parents
What are your weaknesses?: Nothing about them
How do you intend to meet the expenses of this program?: Bank Loan
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 ________________

Last date for payment of application fees has passed. No further application fee payment will be accepted.