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: Nishigandha Tripathy
Mother's Name: Dolly Tripathy
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 Nov 2001 Nationality: Indian
Place of Birth: Sambalpur Personal Identification Mark: Natural
Blood Group: A +  
Date of Birth (DD/MM/YY): 15 Nov 2001 Nationality: Indian
Gender (M/F): Female 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: Kaveri B 302 Greater sambalpur Bareipali Sambalpur
State: Orissa Country: India
Pin: 768001 City/District: Sambalpur
Mobile no: 6371767536 Telephone No. with STD code:
Aadhar Card No:4619 1968 7 993 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Rabi Narayan Tripathy Relationship with candidate: Father
Parents Date of Birth: 19 Sep 1965 Parent's/Guardian's Occupation/Designation: Self employed
Office Address:
Address: Shop no 10 Greater sambalpur Bareipali
Country: India State: Orissa
City/District: Sambalpur Pin: 768001
Tel: Mobile no.: 9437052986
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: Seven Hills Residential School School: Seven Hills Residential School
City: Sambalpur City: Sambalpur
English %: 95 Board Roll No./Seat No.: 6616338
Aggregate Percentage: 95 School/College Code: 53115
  Address of School/College: Pardhiapali Sambalpur
  Centre code: 0000
  Pin: 768006
  Contact Nos:
  Aggregate Percentage: 75
Details of Marks Secured in (10+2) Examination -

Physics 100 67 67
Chemistry 100 75 75
Mathematics 100 54 54
Physics, Chemistry & Mathematics combined Percentage: 65.33
English 100 80 80
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for competitive exams And following my hobbies
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because I love this profession. I have grown up seeing my cousin in merchant navy
Why do you wish to join TMI?: Since it is one of the best Maritime University
What are your hobbies?: Cooking , traveling, reading novels
What are your strengths?: M a very good anchor
What are your weaknesses?: I am little choosy
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 ________________

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