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: DNS2176918 Name: SIDDHARTH K P
  Address: SOPANAM PALLIKURUP POST MANNARKKAD
Telephone No.: Mobile no: 7907352512
E-mail: siddharthkp46@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 282.6 (Includes Convenience fee of ₹ 82.6 ) DD Number: -
Issuing Bank: - Transaction Id: 427670202
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176918 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: DNS2176918
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: SIDDHARTH K P
Mother's Name: SUDHA K P
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 13 Apr 2002 Nationality: INDIAN
Place of Birth: MANNARKKAD Personal Identification Mark: A MOLE BEHIND THE RIGHT EAR
Blood Group: A + Address for Communication: SOPANAM PALLIKURUP POST MANNARKKAD
State: Kerala Country: India
Pin: 678582 City/District: PALAKKAD
Mobile no: 7907352512 Telephone No. with STD code:
Aadhar Card No:905900708709 E-mail: siddharthkp46@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: SUHA K P Relationship with candidate: FATHER
Parents Date of Birth: 26 Apr 1978 Parent's/Guardian's Occupation/Designation: TEACHER
   
Office Address:
   
Address: SABARI HSS PALLIKURUP MANNARKKAD
Country: India State: Kerala
City/District: PALAKKKAD Pin: 678582
Tel: Mobile no.: 9497351601
Fax: Email: sudha2sudhi@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Kerala Board: Kerala
School: SABARI HSS PALLIKURUP School: SABARI HSS PALLIKURUP
City: MANNARKKAD City: MANNARKKAD
English %: 90 Board Roll No./Seat No.: 7253686
Aggregate Percentage: 85 School/College Code: 09163
  Centre code: 427315
  Address of School/College: SABARI HSS PALLIKURUP
  Pin: 678582
  Contact Nos: 04924235161
  Email: hm.shspkp@gmail.com
  Aggregate Percentage: 70
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 200 122 61
Chemistry 200 122 61
Mathematics 200 122 61
Physics, Chemistry & Mathematics combined Percentage: 61
English 100 81 81
   
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
12/2019 BADMINTON DISTRICT 3
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: COACHING CAMP
Why do you wish to join TMI?: TO SECURE FUTURE
What are your hobbies?: READING ,PLAYING BADMINTON
What are your strengths?: MENTAL CAPACITY
What are your weaknesses?: WATCHING TV
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
 
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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