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: CHAITANYA PANDURANG JADHAV
Mother's Name: Radha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Feb 2004 Nationality: INDIAN
Place of Birth: PUNE Personal Identification Mark: Black mole on left shoulder
Blood Group: A +  
Date of Birth (DD/MM/YY): 14 Feb 2004 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: Lane no.- 4, Shreenath Sunderban society Pardesi mala, Phursungi Pune
State: Maharashtra Country: India
Pin: 412308 City/District: PUNE
Mobile no: 7798877051 Telephone No. with STD code: 07798877051
Aadhar Card No:962651107529 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Pandurang Jadhav Relationship with candidate: Father of candidate
Parents Date of Birth: 27 May 1979 Parent's/Guardian's Occupation/Designation: Ex Serviceman
Office Address:
Address: --- ---
Country: India State: Maharashtra
City/District: PUNE Pin: 412308
Tel: 08975237343 Mobile no.: 8975237343
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021 (Appearing for improvement)
Board: CBSE Board: CBSE
School: Army Publlic School Pune School: Army Publlic School Pune
City: PUNE City: PUNE
English %: 89 Board Roll No./Seat No.:
Aggregate Percentage: 82 School/College Code:
  Address of School/College: Ghorpadi Rd, Opp Bank of Maharashtra, Ghorpuri Lines, Dobarwadi, Ghorpadi, Pune, Maharashtra 411001
  Centre code:
  Pin: 411001
  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 ?:
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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