Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science 2021)

Application Summary: Diploma in Nautical Science
Dossier ID: DNS2174689 Name: George S Aykara
  Address: Aykara VELLAPADU PALA P.O
Telephone No.: 08281488094 Mobile no: 8281488094
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 426033761
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2174689 are true and correct.
Signature of Candidate Signature of Parent/Guardian



Date ________________ Date ________________
Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

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


  Dossier ID: DNS2174689
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: George S Aykara
Mother's Name: Nimmi Shibi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 21 Jan 2002 Nationality: Indian
Place of Birth: Kottayam Personal Identification Mark: Mole on left arm
Blood Group: O + Address for Communication: Aykara VELLAPADU PALA P.O
State: Kerala Country: India
Pin: 686575 City/District: Kottayam
Mobile no: 8281488094 Telephone No. with STD code: 08281488094
Aadhar Card No:728792523341 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Shibi M Aykara Relationship with candidate: Father
Parents Date of Birth: 06 Dec 1970 Parent's/Guardian's Occupation/Designation: Hospital manager
Office Address:
Address: Aykara VELLAPADU PALA P.O
Country: India State: Kerala
City/District: Kottayam Pin: 686575
Tel: Mobile no.: 8281488094
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Kerala Board: Kerala
School: Holy Cross Hss Cherpunkal School: Holy Cross hss Cherpunkal
City: PALA City: Cherpunkal
English %: 79 Board Roll No./Seat No.:
Aggregate Percentage: 83 School/College Code:
  Centre code:
  Address of School/College: Cherpunkal Kottayam dt Kerala
  Pin: 668657
  Contact Nos: 08281488094
  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 ?: Learn a new language
Why do you wish to join TMI?: it was always my dream to pursue a career in merchant navy and TMI is one among the best in India and thats why i choose to join in TMI.
What are your hobbies?: Cycling,listening to music
What are your strengths?: open to criticisms
What are your weaknesses?: Shyness and stage fear
How do you intend to meet the expenses of this program?: Own Resources
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet 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 ________________

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