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


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2175106 Name: Jugal Mathew Tom
  Address: Edakkara Cheenkallel H Ramapuram Bazar PO Marangadu 686576
Telephone No.: Mobile no: 7994835651
E-mail: tejaltreesatom@gmail.com  
   
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: 426111589
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175106 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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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: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2021

 
  Dossier ID: DNS2175106
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Jugal Mathew Tom
Mother's Name: Betty Tom
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 11 Mar 2003 Nationality: Indian
Place of Birth: Kottayam Personal Identification Mark: Mole on right arm
Blood Group: A + Address for Communication: Edakkara Cheenkallel H Ramapuram Bazar PO Marangadu 686576
State: Kerala Country: India
Pin: 686576 City/District: Kottayam
Mobile no: 7994835651 Telephone No. with STD code:
Aadhar Card No:327891451096 E-mail: tejaltreesatom@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Tomy Mathew Relationship with candidate: Father
Parents Date of Birth: 10 Apr 1968 Parent's/Guardian's Occupation/Designation: Business
   
Office Address:
   
Address: Edakkara Cheenkallel H Ramapuram Bazar PO Marangadu 686576
Country: India State: Kerala
City/District: Kottayam Pin: 686576
Tel: Mobile no.: 9497821651
Fax: Email: jugaltom7204@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: Kerala
School: Alphonsa Residential School Bharanaganam School: St Augustines Higher Secondary School Karimkunnam
City: Pala City: Thodupuzha
English %: 74 Board Roll No./Seat No.:
Aggregate Percentage: 67 School/College Code:
  Centre code:
  Address of School/College: St Augustines Higher Secondary School Karimkunnam 685586
  Pin: 685586
  Contact Nos:
  Email: jugaltom7204@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
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
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
09/2018 XV Aquatic Meet 4x100m relay Third
 
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?: Swimming,cycling
What are your strengths?: Open to criticisms
What are your weaknesses?: Focus on being self aware
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
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

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Date ________________

 
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