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:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Ayush kumar
Mother's Name: Dropati devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 20 May 2003 Nationality: Indian
Place of Birth: Dhanbad Personal Identification Mark: Mole in neck
Blood Group: B +  
Date of Birth (DD/MM/YY): 20 May 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: Near Baba sweet steel gate saraidhela dhanbad Saraidhela Dhanbad jharkhand
State: Jharkhand Country: India
Pin: 828127 City/District: Dhanbad
Mobile no: 9546571471 Telephone No. with STD code: 8709060590
Aadhar Card No:433501192301 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Lakhan nishad Relationship with candidate: Son
Parents Date of Birth: 12 Apr 1965 Parent's/Guardian's Occupation/Designation: Businessmen
Office Address:
Address: Near Baba sweet steel gate saraidhela dhanbad Saraidhela Dhanbad jharkhand
Country: India State: Jharkhand
City/District: Dhanbad Pin: 828127
Tel: 8797135558 Mobile no.: 9546571471
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2021
Board: CBSE Board: Jharkand
School: S.s.s.s.s gurukulam School: S.p.m collage sindri dhanbad
City: Dhanbad City: Dhanbad
English %: 60 Board Roll No./Seat No.:
Aggregate Percentage: 60 School/College Code:
  Address of School/College: Steel gate saraidhela dhanbad jharkhand
  Centre code:
  Pin: 828127
  Contact Nos: 9546571471
  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: No  
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
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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