Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science )


  Dossier ID: DNS2180720
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: ARJUN KRISHNA AS
Mother's Name: SUSHAMA D
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 29 Jan 2004 Nationality: INDIAN
Place of Birth: KOTTARAKKAR Personal Identification Mark: Black mark in left neck
Blood Group: A + Address for Communication: Gokulam panavely Po Kottarakkara Kollam
State: Kerala Country: India
Pin: 691532 City/District: Kottarakra
Mobile no: 8078013411 Telephone No. with STD code: 8078013411
Aadhar Card No:849725181131 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: ANIL KUMAR G Relationship with candidate: FATHER
Parents Date of Birth: 25 May 1974 Parent's/Guardian's Occupation/Designation: Sadanandapuram
Office Address:
Address: Gokulam panavely Po Kottarakkara
Country: India State: Kerala
City/District: Kottarakra Pin: 691532
Tel: 08078013411 Mobile no.: 8078013411
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Kerala Board: Kerala
School: Govt HSS Sadanandapuram School: Govt Boys HSS Kottarakkara
City: Kottarakra City: Kottarakra
English %: 90 Board Roll No./Seat No.:
Aggregate Percentage: 90 School/College Code:
  Centre code:
  Address of School/College: Gokulam panavely Po Kottarakkara
  Pin: 691532
  Contact Nos: 08078013411
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 200
Chemistry 200
Mathematics 200
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 ?: Yes
Why do you wish to join TMI?: Best college Very good placement record
What are your hobbies?: Violin, Badminton
What are your strengths?: Our Parents
What are your weaknesses?: Mobile and violin
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

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

Signature of Candidate



Date ________________

Last date for payment of application fees has passed. No further application fee payment will be accepted.