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:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Ajith as
Mother's Name: Simi ks
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 17 Apr 2003 Nationality: Indian
Place of Birth: Ernakulam Personal Identification Mark: Left forehead
Blood Group: AB +  
Date of Birth (DD/MM/YY): 17 Apr 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: Koodarappily house Vyttila janatha road Lane 3 Koodarappily house Vyttila janatha road Lane 3 Koodarappily house Vyttila janatha road Lane 3
State: Kerala Country: India
Pin: 682019 City/District: Ernakulam
Mobile no: 7025150793 Telephone No. with STD code:
Aadhar Card No:661771362938 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Simi ks Relationship with candidate: Mother
Parents Date of Birth: 28 Feb 1979 Parent's/Guardian's Occupation/Designation: Housewife
Office Address:
Address: Koodarappily house Vyttila janatha road Lane 3 Nil
Country: India State: Kerala
City/District: Ernakulam Pin: 682019
Tel: Mobile no.: 9656878939
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021 (Appearing for improvement)
Board: CBSE Board: Kerala
School: Sreenarayana vidhyapeedam public school School: Sreenarayana higher secondary school
City: Ernakulam City: Ernakulam
English %: 87 Board Roll No./Seat No.: Nil
Aggregate Percentage: 73 School/College Code: Nil
  Address of School/College: Nil
  Centre code: Nil
  Pin: Nil
  Contact Nos:
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 200 0
Chemistry 200 0
Mathematics 200 0
Physics, Chemistry & Mathematics combined Percentage: 0
English 100 0
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Football ,reading ,music etc
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Yes
Why do you wish to join TMI?: Good carrier option
What are your hobbies?: Football,music,cooking
What are your strengths?: Caring,loving
What are your weaknesses?: Angry
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 ________________