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: DNS2176146 Name: Muhamed Nishal
  Address: Poolakkal house mampad, Kerala, india Panoli house areecode ,Kerala,india
Telephone No.: 09846890092 Mobile no: 9846890092
E-mail: nishal735685@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 429404621
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176146 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: DNS2176146
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Muhamed Nishal
Mother's Name: Jasiya Panoli
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Sep 2002 Nationality: Indian
Place of Birth: Mukkam Personal Identification Mark: Mole in cheek
Blood Group: B + Address for Communication: Poolakkal house mampad, Kerala, india Panoli house areecode ,Kerala,india
State: Kerala Country: India
Pin: 676542 City/District: Mampad Malappuaram
Mobile no: 9846890092 Telephone No. with STD code: 09846890092
Aadhar Card No:218707481852 E-mail: nishal735685@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Mujeeb Rahman Relationship with candidate: Father
Parents Date of Birth: 15 Apr 1976 Parent's/Guardian's Occupation/Designation: Business
   
Office Address:
   
Address: Poolakkal furniture, mampad, kerala Poolakkal furniture mampad,Kerala,india
Country: India State: Kerala
City/District: Mampad Malappuaram Pin: 676542
Tel: Mobile no.: 9048929772
Fax: Email: poolakkal2000@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Kerala
School: Good hope english medium school nilambur School: Nirmala HSS erumamunda
City: Nilambur City: Erumamunda
English %: 84 Board Roll No./Seat No.:
Aggregate Percentage: 84 School/College Code:
  Centre code:
  Address of School/College: Nirmala erumamunda, Malappuram,kerala
  Pin: 679334
  Contact Nos:
  Email: nirmalaerumamubda@gmaip.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
01/2019 Football District Second
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Workout, communication skill, concentrate in physics and maths
Why do you wish to join TMI?: Best college and best infrastructure
What are your hobbies?: Reading books, playing football work out
What are your strengths?: Strong determination and Confidence
What are your weaknesses?: Family income but it is not my weakness
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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