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


  Dossier ID: DNS2174793
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Arun Sagar
Mother's Name: Shailaja
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Jul 2003 Nationality: India
Place of Birth: Ottapalam - Personal Identification Mark: A wound scar near the left elbow
Blood Group: O + Address for Communication: Thottathil house, chalavara po Palakkad dt, Kerala
State: Kerala Country: India
Pin: 679505 City/District: Palakkad
Mobile no: 9567202664 Telephone No. with STD code:
Aadhar Card No:770716153889 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Shailaja Relationship with candidate: Mother
Parents Date of Birth: 12 Oct 1981 Parent's/Guardian's Occupation/Designation: Supplyco store daily wage
Office Address:
Address: Chalavara post Palakkad dt
Country: India State: Kerala
City/District: Palakkad Pin: 679505
Tel: Mobile no.: 9747239130
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Kerala Board: Kerala
School: Chalavara higher secondary school School: Higher secondary school chalavara
City: Chalavara City: Chalavara
English %: 90 Board Roll No./Seat No.:
Aggregate Percentage: 93 School/College Code:
  Centre code:
  Address of School/College: Higher secondary school chalavara, Chalavara post, Palakkad dt
  Pin: 679505
  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 ________________

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