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: DNS2175114 Name: SARATH A
  Address: PLAVULLAKAYA HOUSE, PLAVULLAKAYA PO-KUTTIKOL, 671541 KASARAGOD, KERALA
Telephone No.: Mobile no: 9207518115
E-mail: sarathplavillaya124@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 427148096
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175114 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: DNS2175114
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: SARATH A
Mother's Name: BABY A
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Sep 2002 Nationality: INDIAN
Place of Birth: KANHANGAD Personal Identification Mark: A BLACK MOLE ON THE FOREHEAD
Blood Group: A + Address for Communication: PLAVULLAKAYA HOUSE, PLAVULLAKAYA PO-KUTTIKOL, 671541 KASARAGOD, KERALA
State: Kerala Country: India
Pin: 671541 City/District: KASARAGOD
Mobile no: 9207518115 Telephone No. with STD code:
Aadhar Card No:595145958407 E-mail: sarathplavillaya124@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: C DAMODHARAN NAIR Relationship with candidate: FATHER
Parents Date of Birth: 05 Mar 1963 Parent's/Guardian's Occupation/Designation: AGRICULTURE
   
Office Address:
   
Address: PLAVULLAKAYA PO-KUTTIKOL, 671541 KASARAGOD, KERALA
Country: India State: Kerala
City/District: KASARAGOD Pin: 671541
Tel: Mobile no.: 9526625372
Fax: Email: sarathplavillaya124@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Kerala Board: Kerala
School: CHSS CHATTANCHAL School: CHSS CHATTANCHAL
City: CHATTANCHAL City: CHATTANCHAL
English %: 99 Board Roll No./Seat No.:
Aggregate Percentage: 95 School/College Code:
  Centre code:
  Address of School/College: CHATTANCHAL-MELPARAMBA ROAD. 671541,KASARAGOD
  Pin: 671541
  Contact Nos:
  Email: principalchss@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
08/2019 NATIONAL SERVICE SCHEME WORKED TWO YEARS VOLUNTEER
09/2019 KABADDI FULL CHAMPION
Vocational and Training Courses undertaken:
 
MONTH / YEAR (MM/YYYY) COURSE COURSE DURATION
04/2020 KABADDI 2 MONTHS
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I spend a part of my time for workout ,reading books ,playing and prepare for getting admission in DNS.
Why do you wish to join TMI?: TMI has a good placement record and provide good facility for students.
What are your hobbies?: WORKOUT,READING,PLAYING
What are your strengths?: HARDWORK,HONESTY,PUNCTUALITY
What are your weaknesses?: When I am doing a work I need to put my full effort in that work.
How do you intend to meet the expenses of this program?: Bank Loan
 
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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