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.Sc. Nautical Science
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Harsh Kumar Pathak
Mother's Name: Meena Pathak
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 21 Aug 2003 Nationality: Indian
Place of Birth: Jagdalpur Personal Identification Mark: Mole below the lips
Blood Group: O +  
Date of Birth (DD/MM/YY): 21 Aug 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: Sanjay nagar Railway road In front of ram mandir
State: Chattisgarh Country: India
Pin: 494001 City/District: Jagdalpur
Mobile no: 9399164720 Telephone No. with STD code:
Aadhar Card No:726374974334 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Harish Kumar Pathak Relationship with candidate: Father
Parents Date of Birth: 26 Oct 1962 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: Sanjay nagar Railway road In front of ram mandir
Country: India State: Chattisgarh
City/District: Jagdalpur Pin: 494001
Tel: Mobile no.: 9399164720
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Nirmal higher secondary school School: Nirmal higher secondary school
City: Jagdalpur City: Jagdalpur
English %: 66 Board Roll No./Seat No.:
Aggregate Percentage: 67 School/College Code:
  Address of School/College: Lalbagh, Jagdalpur
  Centre code:
  Pin: 494001
  Contact Nos: 09399164720
  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 have interest in coding. So, I want to learn coding after the exams.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: I want to do marine engineering because it is a rare field.
Why do you wish to join TMI?: I have heard a lot about TMI.
What are your hobbies?: Singing
What are your strengths?: Mother
What are your weaknesses?: Family
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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