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:
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Adarsh Raj Baiju
Mother's Name: Sindhu Baiju
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 11 Jul 2003 Nationality: Indian
Place of Birth: Kochi Personal Identification Mark: Black mole under nose
Blood Group: B + Address for Communication: Aezhuparayil Enadi p o
State: Kerala Country: India
Pin: 686608 City/District: Kottayam
Mobile no: 9946769017 Telephone No. with STD code: 09946769017
Aadhar Card No:891904452401 E-mail: adarshrajbaiju11@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: A R BAIJU Relationship with candidate: Father
Parents Date of Birth: 25 May 1964 Parent's/Guardian's Occupation/Designation: Merchant navy
   
Office Address:
   
Address: Aezhuparayil Enadi p o
Country: India State: Kerala
City/District: Kottayam Pin: 686608
Tel: 09946769017 Mobile no.: 9946769017
Fax: Email: sindhubaiju1271@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: Year of Passing:
Board: Board:
School: School:
City: City:
English %: Board Roll No./Seat No.:
Aggregate Percentage: School/College Code:
  Centre code:
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Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics
Chemistry
Mathematics
Physics, Chemistry & Mathematics combined Percentage:
English
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
 
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
 
Declaration

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

Signature of Candidate

 

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Date ________________

 
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