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: DNS2181139 Name: Arjun R
  Address: JYOTHIS,Hill View Nagar Kanjikode,Palakkad
Telephone No.: Mobile no: 8137076210
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 431969346
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2181139 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: DNS2181139
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Arjun R
Mother's Name: Jyothi D
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 23 Apr 2002 Nationality: Indian
Place of Birth: Palakkad Personal Identification Mark: Black mole on forehead
Blood Group: A + Address for Communication: JYOTHIS,Hill View Nagar Kanjikode,Palakkad
State: Kerala Country: India
Pin: 678623 City/District: Palakkad
Mobile no: 8137076210 Telephone No. with STD code:
Aadhar Card No:371868937009 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Rajesh A Relationship with candidate: son
Parents Date of Birth: 31 Mar 1965 Parent's/Guardian's Occupation/Designation: Private company work
Office Address:
Address: Empee dislleries limited NIDA,Kanjikode industrial area Kanjikode,Palakkad
Country: India State: Kerala
City/District: Palakkad Pin: 678621
Tel: Mobile no.: 9995257118
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Kerala Board: Kerala
City: Palakkad City: Palakkad
English %: 100 Board Roll No./Seat No.: 7222646
Aggregate Percentage: 91 School/College Code: 09019
  Centre code: 678623
  Address of School/College: GVHSS KANJIKODE,Kanjikode,Palakkad
  Pin: 678623
  Contact Nos:
  Aggregate Percentage: 80
Details of Marks Secured in (10+2) Examination -

Physics 200 150 75
Chemistry 200 170 85
Mathematics 200 121 60.5
Physics, Chemistry & Mathematics combined Percentage: 73.5
English 100 80 80
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: I spend my time on preparing for entrance exams
Why do you wish to join TMI?: I heard that TMI is the best institue to achive my dream to join merchant navy
What are your hobbies?: reading books
What are your strengths?: I love to do workout and i am fitness lover
What are your weaknesses?: I didnt had any weakness
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 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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