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: DNS2179910 Name: Ajithp
  Address: Karunya kattukulam, poolakkaparambu Palakkad, kerala 679514
Telephone No.: 6238912803 Mobile no: 6238912803
Application fee payment details:  
Payment Status: offline payment Payment Mode: Offline
Amount: DD Number: -
Issuing Bank: - Transaction Id: -
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2179910 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: DNS2179910
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Ajithp
Mother's Name: Sheeja
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Feb 2003 Nationality: INDIAN
Place of Birth: Ottapalam Personal Identification Mark: Small black mark in left hand
Blood Group: B + Address for Communication: Karunya kattukulam, poolakkaparambu Palakkad, kerala 679514
State: Kerala Country: India
Pin: 679514 City/District: Palakkad
Mobile no: 6238912803 Telephone No. with STD code: 6238912803
Aadhar Card No:417749533870 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Manikandan Relationship with candidate: Father
Parents Date of Birth: 07 May 1971 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: Karunya house Kattukulam, poolakkaparambu 679514
Country: India State: Kerala
City/District: Palakkad Pin: 679514
Tel: 9544072118 Mobile no.: 6238912803
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Kerala Board: Kerala
School: Hss kattukulam School: Hss kattukulam
City: Palakkad City: Palakkad
English %: 70 Board Roll No./Seat No.: 7251347
Aggregate Percentage: 81 School/College Code: 9148
  Centre code: 9148
  Address of School/College: Karunya house kattukulam, poolakkaparambu
  Pin: 67246
  Contact Nos: 6238912803
  Aggregate Percentage: 80
Details of Marks Secured in (10+2) Examination -

Physics 200 161 80.5
Chemistry 200 164 82
Mathematics 200 160 80
Physics, Chemistry & Mathematics combined Percentage: 80.83
English 100 80 80
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
21/11/2019 100mtr Sub district Third
21/11/2019 Long jumb Sub district Third
21/11/2019 Triple jump Sub district Third
21/11/2019 100 relay Sub district First
How do you intend spending your time after completing class XII Final exams and before joining college ?: Prepare examinations in merchant navy sponsorship and playing college team football ball in under calicut University
Why do you wish to join TMI?: This company facilities and features, placement is attracted to me
What are your hobbies?: Playing football, cricket, swimming
What are your strengths?: My time management skills are excellent and I am organized, efficient, take pride in excelling at my work and i pride my self on my skills and my ability to resolve what could be situation
What are your weaknesses?: I am straight forward, my expression are real and cannot fake
How do you intend to meet the expenses of this program?: 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

I hereby declare that all the statements made above are true and correct.

Signature of Candidate



Date ________________

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