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


  Dossier ID: DNS2174553
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Sahal VA
Mother's Name: Summiyya
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Jan 2003 Nationality: Indian
Place of Birth: Kodugallur Personal Identification Mark: Black mole on right shoulder
Blood Group: AB + Address for Communication: Vadakeangadiyil house P. O malapallipuram Thrissur, kerala
State: Kerala Country: India
Pin: 680732 City/District: Thrissur
Mobile no: 9847614484 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Anvar VS Relationship with candidate: Father
Parents Date of Birth: 25 May 1970 Parent's/Guardian's Occupation/Designation: Electrical Engineer
Office Address:
Address: Vadakeangadiyil house P. O malapallipuram
Country: India State: Kerala
City/District: Thrissur Pin: 680732
Tel: Mobile no.: 8113947247
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Kerala
School: Al-Azhar School: Gshss meladoor
City: Mala City: Meladooe
English %: 85 Board Roll No./Seat No.:
Aggregate Percentage: 69 School/College Code:
  Centre code:
  Address of School/College: Meladoor Alathur-12 Kerala India 680741
  Pin: 680732
  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 ?: By prepareing for imu cet
Why do you wish to join TMI?: A plus graded institution
What are your hobbies?: Reading, hiking
What are your strengths?: Mind set
What are your weaknesses?: I can only concentrate one thing at time
How do you intend to meet the expenses of this program?: Own Resources
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.