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: DNS2177474
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Fazil Abdulla Salam
Mother's Name: Nisha Beegam TS
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 17 Jul 2002 Nationality: Indian
Place of Birth: N.Paravur Personal Identification Mark: Black mark above the left hand wrist
Blood Group: O + Address for Communication: KATTISSERY KOLLIYIL 81 PATTANAM, Vadakkekara P.O,N.Paravur
State: Kerala Country: India
Pin: 683522 City/District: ERNAKULAM
Mobile no: 9633243837 Telephone No. with STD code: 07591915896
Aadhar Card No: E-mail: fazilp5363@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Salam KA Relationship with candidate: Son
Parents Date of Birth: 10 Oct 1964 Parent's/Guardian's Occupation/Designation: Buisness
   
Office Address:
   
Address: KATTISSERY KOLLIYIL 81 PATTANAM, Vadakkekara P.O,N.Paravur
Country: India State: Kerala
City/District: ERNAKULAM Pin: 683522
Tel: 07591915896 Mobile no.: 9633243837
Fax: Email: fazilp5363@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: HDPY SENIOR SECONDARY SCHOOL School: LITTLE HEARTS
City: ERNAKULAM City: North Paravur
English %: 88 Board Roll No./Seat No.:
Aggregate Percentage: 89 School/College Code:
  Centre code:
  Address of School/College: KIZHAKKEPRAM, North PARAVUR
  Pin: 683513
  Contact Nos: 04842446939
  Email: littleheartsschool97@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:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: I would like to utilise that time for Entrace examination
Why do you wish to join TMI?: Best educational institute
What are your hobbies?: Football,singing,dancing
What are your strengths?: Self confidence
What are your weaknesses?: Height
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 ________________

 
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