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.Sc. Nautical Science
Dossier ID: DEG2169450
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Yash Nigam
Mother's Name: Arti Nigam
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 06 Sep 2004 Nationality: Indian
Place of Birth: Kanpur Personal Identification Mark: A mole on right cheek
Blood Group: A +  
Date of Birth (DD/MM/YY): 06 Sep 2004 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: House No. H-1536 Satyam Vihar, Keshavpuram Kalyanpur
State: Uttar Pradesh Country: India
Pin: 208017 City/District: Kanpur Nagar
Mobile no: 9415932390 Telephone No. with STD code:
Aadhar Card No:840340774196 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Pradeep Nigam Relationship with candidate: Father
Parents Date of Birth: 09 Jan 1974 Parent's/Guardian's Occupation/Designation: Government Service
Office Address:
Address: Office Of District Magistrate Civil Lines Kanpur Nagar
Country: India State: Uttar Pradesh
City/District: Kanpur Nagar Pin: 208001
Tel: 9415932390 Mobile no.: 9415932390
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Maharana Pratap Education Centre School: Maharana Pratap Education Centre
City: Kanpur City: Kanpur
English %: 90 Board Roll No./Seat No.:
Aggregate Percentage: 85 School/College Code:
  Address of School/College: Keshavpuram, Kalyanpur, Kanpur
  Centre code:
  Pin: 208017
  Contact Nos: 9415932390
  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 ?: Preparation of competative exams
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: It gives bright future and I like this
Why do you wish to join TMI?: In TMI I will get best training and good placement
What are your hobbies?: Playing musical instrument Tabla
What are your strengths?: achievement of goal
What are your weaknesses?: never give up aim
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 ________________