This page is for your reference only. Do not include this page when sending your printed application

 

Instructions

Please quote your application form no. and full name for any future correspondence.

Please ensure that you send the following documents with your application.

  1. Write "Application for Marine Engineering/ Nautical Technology, Form No." on the envelope.
  2. Print the application form duly filled.
  3. The application summary duly signed where indicated.
  4. Three identical recent passport size photographs with name & form no. written at the back.
  5. Copies of Class X marksheet and Pass Certificate attested by Gazetted Officer.
  6. Copies of Class XII marksheet and Pass Certificate attested by Gazetted Officer. Applicants who have not received these documents may submit a bona fide certificate from the head of the school or college where they appeared for these exams.
  7. Downloaded copies of class XII marksheet from internet attested by school Principal. Candidates appearing for Class XII exam in 2015 may submit these copies after declaration of results.
  8. Attested Copy of School Leaving Certificate / Transfer Certificate (for proof of age).
  9. Attested Copy of Birth Certificate (for proof of age and place of Birth).
  10. Copies of Sports and Extra Curricular Activities (Class VIII and above only).
  11. A demand draft for Rs. 1000/- favouring "Tolani Maritime Institute" payable at Pune or the counterfoil (TMI Office Copy) received from the bank, if already paid in Axis Bank branch or online payment. Write your name, form number and contact details on the reverse of the Demand Draft.

Send duly filled Application Forms to:

Tolani Maritime Institute
Talegaon - Chakan Road
Induri, Talegaon
Pune - 410 507

Note: Please remember to login and fill in your 12th std PCM marks when they are published in order to complete your application form.


To,
Tolani Maritime Institute
Talegaon - Chakan Road
Induri, Talegaon
Pune - 410 507

Application Summary

Form No.:
Name:
Photo:
   
Address:
   
Telephone No:
E-mail Address:
Mobile No:
 
Application Fee Payment Details:

You have chosen to pay by Cash/DD at select branches of Axis Bank or at the counter at TMI. If you have paid at Axis Bank please enclose the counterfoil (TMI Office Copy) received from the bank. If you are paying at the counter at TMI please enclose the DD and complete the information below. The DD must be for Rs. 1000/- and payable at Pune. Write your name, form number and contact details on the reverse of the Demand Draft.

 
DD Issuing Bank:  
Date:  
DD Number:  
Amount:  
 
Declaration
We hereby declare that all the statements made in Application Form No. are true and correct.
     
     
     
Signature of Candidate   Signature of Parent/Guardian
Date:   Date:
     

Form Number:

Program preference:

Applicant's Personal Information:

Full Name:

Date of Birth:
Nationality:
Gender: Female
Marital Status: Single
Place of Birth:
Personal Identification mark:
Photograph:

Address for Communication:- (Postal Codes & STD Dial Codes must be included)

House / Building No.:
Street / Lane:
Village / Post Office / Tehsil:
City / District:
PIN:
Country:
State:
Telephone No. (with STD code) : -
Mobile:
E-mail:

Guardian's Particulars

Name of Father/Guardian:
Father/Guardian's Occupation / Designation:
Address:
Tel: -
Mobile:
Fax: -
E-mail:

Education and Academic Record

  Class X Class XII
Year of Passing:
Board:
School:
Aggregate: % %
English: % %
XII Board Roll No. / Seat No.:  

Vocational and training courses undertaken in the last 5 years if any:

Class Course Date Course Duration
How do you intend to meet the expenses of this program?

Online Admission Test

Declaration

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

 

 

 

 

   
Signature of Candidate   Signature of Parent/Guardian
Date:   Date:

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