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: DNS2176251 Name: Bestin baby
  Address: Mullamkuzhiyil House Piravom P.O
Telephone No.: Mobile no: 9747198544
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 426931399
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176251 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: DNS2176251
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Bestin baby
Mother's Name: Siji Jose
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 27 Feb 2003 Nationality: Indian
Place of Birth: Kottayam Personal Identification Mark: A black mole on left side of neck
Blood Group: O + Address for Communication: Mullamkuzhiyil House Piravom P.O
State: Kerala Country: India
Pin: 686664 City/District: Ernakulam
Mobile no: 9747198544 Telephone No. with STD code:
Aadhar Card No:365500261244 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: M M Baby Relationship with candidate: Father
Parents Date of Birth: 30 May 1968 Parent's/Guardian's Occupation/Designation: Real Estate
Office Address:
Address: Mullamkuzhiyil House Piravom P.O
Country: India State: Kerala
City/District: Ernakulam Pin: 686664
Tel: Mobile no.: 9947901832
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Kerala
School: Holy Kings Public School School: Mariagiri EMHSS
City: Ernakulam City: Idukki
English %: 68 Board Roll No./Seat No.:
Aggregate Percentage: 56 School/College Code:
  Centre code:
  Address of School/College: Mariagiri EMHSS,Peerumedu Idukki
  Pin: 685531
  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
04/2021 Basketball State 1st
04/2021 Swimming Panchayat 3rd
How do you intend spending your time after completing class XII Final exams and before joining college ?: Swimming and Basketball
Why do you wish to join TMI?: it my burning desire to be part of vessel. TMI provide an excellent opportunity for fulfilment of my passion.
What are your hobbies?: Swimming and Basketball
What are your strengths?: Puntual,leadership
What are your weaknesses?: Nervous
How do you intend to meet the expenses of this program?: Own Resources,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 ________________

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