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: Bharat patidar
Mother's Name: Shobha patidar
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 23 Sep 2003 Nationality: Indian
Place of Birth: Multhan Personal Identification Mark: Black spot near eye
Blood Group: O +  
Date of Birth (DD/MM/YY): 23 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: Patidar Mohalla multhan New colony multhan
State: Madhya Pradesh Country: India
Pin: 454660 City/District: Dhar
Mobile no: 9179782349 Telephone No. with STD code:
Aadhar Card No:462863525814 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Shantilal patidar Relationship with candidate: Father
Parents Date of Birth: 09 Jul 1978 Parent's/Guardian's Occupation/Designation: 12th pass
Office Address:
Address: New colony multhan Patidar mohalla multhan
Country: India State: Madhya Pradesh
City/District: Dhar Pin: 454660
Tel: Mobile no.: 6265066994
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Kasyap vidhyapeeth School: Lotus international school
City: Badnawar City: Kanwan
English %: 69 Board Roll No./Seat No.:
Aggregate Percentage: 75 School/College Code:
  Address of School/College: Near Kanwan
  Centre code:
  Pin: 454665
  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 ?: I will spend some time with family and some time in preparation of competitive exam
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because I am to much interested in it.
Why do you wish to join TMI?: Because it is best among all the colleges.
What are your hobbies?: Kabbadi
What are your strengths?: Good in maths
What are your weaknesses?: Weak in nothing
How do you intend to meet the expenses of this program?: Own Resources
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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