Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
Marine Engineering / Nautical Science Degree Programmes
(New Admission B.Tech. Marine Engineering / B.Sc. Nautical Science )


Course: First Choice B.Sc. Nautical Science Course: Second Choice B.Tech. Marine Engineering
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Varsolkar Gaurav Jagdish
Mother's Name: Rekha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 09 Sep 2003 Nationality: Indian
Place of Birth: Navi Mumbai Personal Identification Mark: Birth mark on the right of my belly
Blood Group: O +  
Date of Birth (DD/MM/YY): 09 Sep 2003 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Passport No.:
Date of Expiry: Place of Issue:
(Note: If you do not have passport, you may apply for it as early as possible as passport is required for obtaining Seaman’s Discharge Certificate, mandatory for boarding a ship.)
Address for Communication: E-21/201, Dreamland CHS Sector-4 Sanpada Navi Mumbai 400705
State: Maharashtra Country: India
Pin: 400705 City/District: Navi Mumbai
Mobile no: 9930576393 Telephone No. with STD code:
Aadhar Card No:958881327025 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Rekha Varsolkar Relationship with candidate: Son
Parents Date of Birth: 24 Dec 1970 Parent's/Guardian's Occupation/Designation: Service
Office Address:
Address: DPS,2nd Floor Cash Section,BARC, Vikram Sarabhai Bhawan,Anushakti Nagar Mumbai 94
Country: India State: Maharashtra
City/District: Mumbai Pin: 400094
Tel: Mobile no.: 9869531351
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: High School Sanpada Vivekanand Sankul School: Terna Vidyalaya
City: Navi Mumbai City: Navi Mumbai
English %: 79 Board Roll No./Seat No.:
Aggregate Percentage: 75 School/College Code:
  Address of School/College: E-1/26, Sector 12 Nerul Rd, Dharshana Society, Hatole Gaothan, Sector 10, Nerul, Navi Mumbai, Maharashtra 400706
  Centre code:
  Pin: 400706
  Contact Nos:
  Aggregate Percentage: 83
Details of Marks Secured in (10+2) Examination -

Physics 100 81 81
Chemistry 100 77 77
Mathematics 100 83 83
Physics, Chemistry & Mathematics combined Percentage: 80.33
English 100 84 84
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?:
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:
Your passport not uploaded Class X marksheet not uploaded Leaving / Transfer Certificate / Birth 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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