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


  Dossier ID: DNS2174604
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Rahda jabin
Mother's Name: Bushra beegam
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 27 Nov 2002 Nationality: Indian
Place of Birth: Kerala Personal Identification Mark: A mole on the right foot
Blood Group: B + Address for Communication: Mattil house Parathakkad Muthuparamb
State: Kerala Country: India
Pin: 673638 City/District: Malappuram
Mobile no: 9947668573 Telephone No. with STD code:
Aadhar Card No:670359172392 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Abdurahiman mattil Relationship with candidate: Father
Parents Date of Birth: 05 Mar 1974 Parent's/Guardian's Occupation/Designation: Abroad
Office Address:
Address: Mattil Parathakkad
Country: India State: Kerala
City/District: Malappuram Pin: 673638
Tel: Mobile no.: 7034181473
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2021
Board: Kerala Board: Kerala
School: Ptmhss kodiyathoor School: Emeahss kondotty
City: Kozhikode City: Kondotty
English %: 100 Board Roll No./Seat No.:
Aggregate Percentage: 100 School/College Code:
  Centre code:
  Address of School/College: Kondotty Malappuram Kerala
  Pin: 673638
  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 ?: Reading and spending time on working out
Why do you wish to join TMI?: It has always been a dream to study there ,your facilities and courses
What are your hobbies?: Reading ,listening musics
What are your strengths?: I good at anything If i put my mind on it
What are your weaknesses?: Dont eat seafood
How do you intend to meet the expenses of this program?: Own Resources,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.