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: DNS2180504 Name: shaun roland
  Address: shaun roland s/o, capt. vijayan francis, 11/40, st antony street pozhikarai.po s/o, capt. vijayan francis, 11/40, st antony street pozhikarai.po eathamozhi.via
Telephone No.: +91 9080211572 Mobile no: 9080211572
E-mail: shaunroland70@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 431492884
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2180504 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: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2021

 
  Dossier ID: DNS2180504
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: shaun roland
Mother's Name: Meble mary suba
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 02 Feb 2004 Nationality: Indian
Place of Birth: visakhapatn Personal Identification Mark: a block mole on left hand l bow
Blood Group: B + Address for Communication: shaun roland s/o, capt. vijayan francis, 11/40, st antony street pozhikarai.po s/o, capt. vijayan francis, 11/40, st antony street pozhikarai.po eathamozhi.via
State: Tamil Nadu Country: India
Pin: 629501 City/District: kaniyakumari
Mobile no: 9080211572 Telephone No. with STD code: +91 9080211572
Aadhar Card No:904749255079 E-mail: shaunroland70@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: capt vijayan francis Relationship with candidate: father
Parents Date of Birth: 29 Nov 1971 Parent's/Guardian's Occupation/Designation: marine master
   
Office Address:
   
Address: s s offshore 4thfloor viraj impex house, 47, pd mello road, masjid bandar -e mumbai maharashtra s s offshore 4thfloor viraj impex house, 47, pd mello road, masjid bandar -e
Country: India State: Maharashtra
City/District: mumbai Pin: 400009
Tel: 917598724340 Mobile no.: 7598724340
Fax: Email: francisvijayan70@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Tamil Nadu Board: Tamil Nadu
School: alphonsa matriculation hi.sec school School: alphonsa matriculation hi.sec school
City: kaniyakumari City: kaniyakumari
English %: 87 Board Roll No./Seat No.:
Aggregate Percentage: 78 School/College Code:
  Centre code:
  Address of School/College: alphonsa marticulation school arp camp road, alphonsa nager nagercoil
  Pin: 629002
  Contact Nos: 04652265863
  Email: alphonsaschool@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: 1618325498  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: attending type writting class and computer application course
Why do you wish to join TMI?: learn more knowledge about ship operation and improve my family back ground and earn more money and becoming master mariner
What are your hobbies?: playing cricket
What are your strengths?: i am a hard worker
What are your weaknesses?: i get stressed when i get stressed
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 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