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: DNS2175185 Name: Thomas Kanjooparambil Rajeev
  Address: Pulickel House, Ruby Nagar P.O., Changanacherry
Telephone No.: 08281801483 Mobile no: 8281801483
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 426209142
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175185 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: DNS2175185
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Thomas Kanjooparambil Rajeev
Mother's Name: Anjali George
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 17 Mar 2004 Nationality: Indian
Place of Birth: Kerala Personal Identification Mark: A black mole on the right side of the trunk above the waist
Blood Group: O + Address for Communication: Pulickel House, Ruby Nagar P.O., Changanacherry
State: Kerala Country: India
Pin: 686103 City/District: Kottayam
Mobile no: 8281801483 Telephone No. with STD code: 08281801483
Aadhar Card No:944711997946 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Anjali George Relationship with candidate: Mother
Parents Date of Birth: 08 Jul 1976 Parent's/Guardian's Occupation/Designation: Assistant Professor
Office Address:
Address: Department of English, St. Josephs College for Women Convent Square
Country: India State: Kerala
City/District: Alappuzha Pin: 688001
Tel: 4812401940 Mobile no.: 9633923540
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: AKM Public School School: AKM Public School
City: Changanacherry City: Changanacherry
English %: 94 Board Roll No./Seat No.:
Aggregate Percentage: 90 School/College Code:
  Centre code:
  Address of School/College: AKM Public School and Junior College, Ruby Nagar P.O Morkulangara Changanacherry.
  Pin: 686103
  Contact Nos: 04812402161
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
09/2017 Basketball State level First
08/2018 Basketball State level Participation
04/2019 Basketball State level Participation
10/2018 Basketball District level Second
Vocational and Training Courses undertaken:
08/2017 District Basketball Camp 15 Days
08/2018 District Basketball Camp 7 Days
04/2019 District Basketball Camp 7 Days
How do you intend spending your time after completing class XII Final exams and before joining college ?: I intend to prepare for the upcoming entrance exams, catching up on daily workouts, getting ready for my driving test.
Why do you wish to join TMI?: I came to know about Tolani from one of my uncles and my fascination for the sea motivated me to know more about Tolani from the web. The wholesome development of the students and the employees that Tolani focuses on inspired me to decide that I to should be part of the Tolani family.
What are your hobbies?: My hobbies include swimming, playing basketball, gardening and cooking.
What are your strengths?: I am intelligent, compassionate and adventurous.
What are your weaknesses?: I maybe over-reactive, impulsive and suspicious at times.
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

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

Signature of Candidate



Date ________________

Print Summary and Application Form