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


  Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Amal renny
Mother's Name: Valsa renny
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 30 Dec 2002 Nationality: Indian
Place of Birth: Kerala Personal Identification Mark: Black mole on right side of nose
Blood Group: A + Address for Communication: Thottumakara house Ochanthuruth P. 0 Vypin
State: Kerala Country: India
Pin: 682508 City/District: Ernakulam
Mobile no: 9995792339 Telephone No. with STD code:
Aadhar Card No:827633141555 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Renny augustine Relationship with candidate: Father
Parents Date of Birth: 20 Mar 1995 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: Thottumakara house Ochanthuruth P. 0 Vypin
Country: India State: Kerala
City/District: Ernakulam Pin: 682508
Tel: Mobile no.: 9400253237
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Assisi vidyaniketan public school School: Assisi vidyaniketan public school
City: Kochi City: Kochi
English %: 89 Board Roll No./Seat No.:
Aggregate Percentage: 76 School/College Code:
  Centre code:
  Address of School/College: Assisi vidyaniketan public school perumpilly
  Pin: 682505
  Contact Nos: 09400253237
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
10/19 Basketball Cluster state First
11/19 Basketball Cluster national First
How do you intend spending your time after completing class XII Final exams and before joining college ?: I will prepare for imu cet exam and other sponsored exams
Why do you wish to join TMI?: I wish to join tmi because its a well reputed college and provides good placement
What are your hobbies?: Travelling
What are your strengths?: Self confidence
What are your weaknesses?: Tension
How do you intend to meet the expenses of this program?: Own Resources,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 ________________

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