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: GOWTHAM B
Mother's Name: RAJITHA KUMARI K L
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 03 May 2003 Nationality: Indian
Place of Birth: Alappuzha Personal Identification Mark: A black mole on the left hand point finger
Blood Group: B + Address for Communication: VAISAKHAM, KADOOR KALARCODE SANATHANAPURAM PO
State: Kerala Country: India
Pin: 688003 City/District: Alappuzha
Mobile no: 9847528250 Telephone No. with STD code:
Aadhar Card No:483931984746 E-mail: rejithavaisakham@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Rajitha Kumari K L Relationship with candidate: Mither
Parents Date of Birth: 03 May 1972 Parent's/Guardian's Occupation/Designation: Bank employee
   
Office Address:
   
Address: Vaisakham Kadoor SANATHANAPURAM P O
Country: India State: Kerala
City/District: Alappuzha Pin: 688003
Tel: Mobile no.: 9847528250
Fax: Email: rejithavaisakham@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Chinmaya Vidyalaya School: Govt. VHSS Aryad
City: Alappuzha City: Alappuzha
English %: 92 Board Roll No./Seat No.:
Aggregate Percentage: 85 School/College Code: 04096
  Centre code:
  Address of School/College: Aryad South, Alappuzha
  Pin: 688006
  Contact Nos:
  Email: aryadgvhss04096@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
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
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
05/2016 Taekwondo District level Redone belt holder
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Reading book related to higher studies
Why do you wish to join TMI?: I believe I will get good opportunity to grow my career through TMI
What are your hobbies?: Reading, Wieght lifting, swimming
What are your strengths?: Self confident
What are your weaknesses?: Anger
How do you intend to meet the expenses of this program?: Bank Loan
 
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 ________________

 
Print Summary and Application Form