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: CHODIPILLI RAMESH
Mother's Name: CHODIPILLI LAXMI
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Feb 2002 Nationality: India
Place of Birth: KUNDUVANIPE Personal Identification Mark: One mole on right hand side and one other mole on left side neck
Blood Group: O + Address for Communication: KUNDHUVANIPETA,PATHURU CHINNA RACHABANDDA
State: Andhra Pradesh Country: India
Pin: 532401 City/District: SRIKAKULAM
Mobile no: 6302250995 Telephone No. with STD code: 06302250995
Aadhar Card No:944383533536 E-mail: chodipilliramesh084@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: CHODIPILLI LAXMI Relationship with candidate: MOTHER
Parents Date of Birth: 01 Jan 1981 Parent's/Guardian's Occupation/Designation: HOUSE MAKER
   
Office Address:
   
Address: KUNDHUVANIPETA,PATHURU CHINNA RACHABANDDA
Country: India State: Andhra Pradesh
City/District: SRIKAKULAM Pin: 532401
Tel: 06302250995 Mobile no.: 9652566809
Fax: Email: chodipilliramesh084@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: Year of Passing:
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School: School:
City: City:
English %: Board Roll No./Seat No.:
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Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
Physics, Chemistry & Mathematics combined Percentage:
English
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
 
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

 

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Date ________________

 
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