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:
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Adarsh K P
Mother's Name: Bindu M
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 06 Jul 2002 Nationality: Indian
Place of Birth: kerala Personal Identification Mark: scar mark on right hand elbow
Blood Group: O + Address for Communication: Kakkadath palattu kizhakkedath parambu Beypore, kozhikode, kerala Pin-673015
State: Kerala Country: India
Pin: 673015 City/District: Kozhikode
Mobile no: 9961167133 Telephone No. with STD code:
Aadhar Card No:898918544588 E-mail: adarshkakkadath1@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: SASIDHARAN KP Relationship with candidate: FATHER
Parents Date of Birth: 05 Jan 1973 Parent's/Guardian's Occupation/Designation: SELF EMPLOYED
   
Office Address:
   
Address: Kakkadath palattu kizhakkedath parambu Beypore, kozhikode, kerala Pin-673015
Country: India State: Kerala
City/District: Kozhikode Pin: 673015
Tel: Mobile no.: 9961167133
Fax: Email: adarshkakkadath1@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: J N V PALAYAD NADA PO BADAGARA CALICUT DT KERALA School: J N V PALAYAD NADA PO BADAGARA CALICUT DT KERALA
City: Kozhikode City: Kozhikode
English %: 84 Board Roll No./Seat No.: 24632500
Aggregate Percentage: 84 School/College Code: 79010
  Centre code: 7685
  Address of School/College: Palayadnada Post, Vadakara Kozhikode, Palayad, Maniyur, Kerala 673521
  Pin: 673015
  Contact Nos:
  Email: jnvkozhikode@gmail.com
  Aggregate Percentage: 78
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100 74 74
Chemistry 100 70 70
Mathematics 100 72 72
Physics, Chemistry & Mathematics combined Percentage: 72
English 100 95 95
   
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
 
Declaration

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

Signature of Candidate

 

___________________

Date ________________

 
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