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.Tech. Marine Engineering Course: Second Choice B.Tech. Marine Engineering
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Mukunda Nand Dwivedi
Mother's Name: Maya Dwivedi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 30 Apr 2004 Nationality: Indiaan
Place of Birth: Odhisa Personal Identification Mark: Mole on right side of chin
Blood Group: A -  
Date of Birth (DD/MM/YY): 30 Apr 2004 Nationality: Indiaan
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: Pakari bisunpur Maharajganj
State: Uttar Pradesh Country: India
Pin: 273151 City/District: Maharajganj
Mobile no: 8948634541 Telephone No. with STD code:
Aadhar Card No:423598901765 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: SACHCHIDA nanad Dwivedi Relationship with candidate: Father
Parents Date of Birth: 01 Oct 1967 Parent's/Guardian's Occupation/Designation: Service
Office Address:
Address: Near cahrbagh railway station Lucknow
Country: India State: Uttar Pradesh
City/District: Lucknow Pin: 226006
Tel: Mobile no.: 9793972843
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Lucknow Public School School: Lucknow Public School
City: Lucknow City: Lucknow
English %: 92 Board Roll No./Seat No.:
Aggregate Percentage: 84 School/College Code:
  Address of School/College: Sec i lda colony ashiyana lucknow
  Centre code:
  Pin: 226006
  Contact Nos:
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Focus on gaining strengthGetting physically and mentally fit.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: It gives us a wide range of services. Knowledge and help us to develop ourselves with the help of nature .
Why do you wish to join TMI?: It is one of the best marine collages. The professor are good
What are your hobbies?: Writing
What are your strengths?: Quick learner
What are your weaknesses?: Antisocial
How do you intend to meet the expenses of this program?: Bank Loan
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 ________________

Print Summary and Application Form