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: DNS2175878 Name: SREEDEEP D
  Address: Kochukalampukattu Mannanam PO Kottayam
Telephone No.: Mobile no: 6282841789
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: 427809301
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175878 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: DNS2175878
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: SREEDEEP D
Mother's Name: Indu G
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Mar 2003 Nationality: Indian
Place of Birth: Thellakam Personal Identification Mark: mole in right hand
Blood Group: A + Address for Communication: Kochukalampukattu Mannanam PO Kottayam
State: Kerala Country: India
Pin: 686561 City/District: Kottayam
Mobile no: 6282841789 Telephone No. with STD code:
Aadhar Card No:420177147821 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Deepak K Relationship with candidate: Father
Parents Date of Birth: 30 Apr 1971 Parent's/Guardian's Occupation/Designation: Public Sector Employee
Office Address:
Address: KSFE Elikkulam Kottayam
Country: India State: Kerala
City/District: Kottayam Pin: 686561
Tel: Mobile no.: 9446385027
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: Kerala
School: Kuriakose Elias English Medium School School: St.Ephrems Mannanam
City: Kottayam City: Kottayam
English %: 82 Board Roll No./Seat No.:
Aggregate Percentage: 87 School/College Code:
  Centre code:
  Address of School/College: St.Ephrems Mannanam PO Kottayam
  Pin: 686561
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
09/2018 Football Interschool tournament Participants
04/2017 Cricket District level coaching camp participant
08/2019 Drama School level Winner
Vocational and Training Courses undertaken:
04/2017 Swimming 2 months
04/2019 Guitar 3 months
06/2017 Roller skating 1 year
How do you intend spending your time after completing class XII Final exams and before joining college ?: I have planned to join a coaching center for IMUCET . In off days I have planned to visit some tourist places and also spend time on watching movies,playing cricket football etc
Why do you wish to join TMI?: I wish to join TMI because of its quality in education,placements and infrastructure. Moreover it is one of the best institution for maritime studies.
What are your hobbies?: Football,cricket,cycling,bodybuilding,swimming and fishing.
What are your strengths?: Dedication,taking initiative,focused.
What are your weaknesses?: I will not get satisfaction untill that work is completed by a complete focused mind.
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

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

Signature of Candidate



Date ________________

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