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

APPLICATION FOR ADMISSION - 2021

 
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: Shaun Mascarenhas
Mother's Name: Manil
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 04 Jun 2003 Nationality: Indian
Place of Birth: Bhopal Personal Identification Mark: Black spot under left eye
Blood Group: A +  
 
Date of Birth (DD/MM/YY): 04 Jun 2003 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Shaun Mascarenhas Passport No.: U3756677
Date of Expiry: 19 Jan 2031 Place of Issue: Ahmedabad
(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: D-74, street number-3 Ram Mantra Mandir, Kaliyabid Bhavnagar
State: Gujarat Country: India
Pin: 364002 City/District: Bhavnagar
Mobile no: 8160356729 Telephone No. with STD code:
Aadhar Card No:425098537972 E-mail: shaunmascarenhas040@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Adrian Mascarenhas Relationship with candidate: Father
Parents Date of Birth: 18 Nov 1974 Parent's/Guardian's Occupation/Designation: Senior manager
   
Office Address:
   
Address: Ultratech cement Kotputli, Jaipur
Country: India State: Rajasthan
City/District: Jaipur Pin: 303108
Tel: Mobile no.: 9904201153
Fax: Email: axm16@yahoo.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: Year of Passing:
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  Address of School/College:
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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 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
 
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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