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: DEG2169453
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Shudhanshu pal
Mother's Name: Malti devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 05 Aug 2002 Nationality: India
Place of Birth: Bhongoan Personal Identification Mark: Mole on the back left ear
Blood Group: O +  
Date of Birth (DD/MM/YY): 05 Aug 2002 Nationality: India
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: Chhajarsi sector 63 Noida Chhijarshi, sector 63 Noida
State: Uttar Pradesh Country: India
Pin: 201301 City/District: Noida
Mobile no: 9911412558 Telephone No. with STD code:
Aadhar Card No:496267761136 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Anarsingh pal Relationship with candidate: Father
Parents Date of Birth: 01 Sep 1976 Parent's/Guardian's Occupation/Designation: Ups reparing Engineer
Office Address:
Address: Chhajarsi sector 63 Noida Chhijarshi, sector 63 Noida
Country: India State: Uttar Pradesh
City/District: Noida Pin: 201301
Tel: 09911412558 Mobile no.: 9818756933
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: New rainbow public school School: New rainbow public school
City: Ghaziabad City: Ghaziabad
English %: 93 Board Roll No./Seat No.:
Aggregate Percentage: 91 School/College Code:
  Address of School/College: Sector 12 ,pratap vihar Ghaziabad
  Centre code:
  Pin: 201009
  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 have join swimming classes
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: I have to know more about searoutes.
Why do you wish to join TMI?: Because TMI is best institute for marine in india
What are your hobbies?: Swimming, cricket,
What are your strengths?: Leadership, motivation, temperless
What are your weaknesses?: Speech in public
How do you intend to meet the expenses of this program?: Own Resources
Review you documents:
Your passport not uploaded Class X marksheet Leaving / Transfer Certificate / Birth Certificate 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 ________________