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: DEG2169623
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Siya kumari
Mother's Name: Rupa devi
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 09 Oct 2002 Nationality: Indian
Place of Birth: Home delive Personal Identification Mark: Mole on neck
Blood Group: A +  
Date of Birth (DD/MM/YY): 09 Oct 2002 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: Ghatotand Ranchi
State: Jharkhand Country: India
Pin: 825314 City/District: Ramgarh
Mobile no: 7903611127 Telephone No. with STD code: 06553
Aadhar Card No:634886790559 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Parmeshwar Kumar Agaria Relationship with candidate: No relationship
Parents Date of Birth: 02 Aug 1983 Parent's/Guardian's Occupation/Designation: FCO CAT - V P0026361
Office Address:
Address: Ghatotand Ranchi
Country: India State: Jharkhand
City/District: Ramgarh Pin: 825324
Tel: 06553 Mobile no.: 7903611127
Fax: 06553 Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Holy Cross school School: Holy Cross school
City: Ghatotand City: Ghatotand
English %: 86 Board Roll No./Seat No.:
Aggregate Percentage: 77 School/College Code:
  Address of School/College: West Bokaro ghatotand, Ramgarh
  Centre code:
  Pin: 825314
  Contact Nos: 7903611127
  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 ?: Go on tour
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: For job security
Why do you wish to join TMI?: I wish to travel around the world
What are your hobbies?: Swimming
What are your strengths?: Honesty, patience, writting skills
What are your weaknesses?: Lack of experience
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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