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: Board of high school and intermediate education up
Mother's Name: Girish devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 02 May 2003 Nationality: Hindu
Place of Birth: Mahamadpur Personal Identification Mark: Tiwaripur
Blood Group: A +  
Date of Birth (DD/MM/YY): 02 May 2003 Nationality: Hindu
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: Mahamdpur Tiwaripur Mahamadpur Tiwaripur post-Ashapur
State: Uttar Pradesh Country: India
Pin: 222203 City/District: Jaunpur
Mobile no: 8175044032 Telephone No. with STD code:
Aadhar Card No:587849175373 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Krishn kant Tiwari Relationship with candidate: Friend
Parents Date of Birth: 02 Apr 1983 Parent's/Guardian's Occupation/Designation: No
Office Address:
Address: Mahamdpur Tiwaripur Mahamadpur Tiwaripur
Country: India State: Uttar Pradesh
City/District: Jaunpur Pin: 222203
Tel: Mobile no.: 8175044032
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Uttar Pradesh Board: Uttar Pradesh
School: H N S M Academy Dhanuha Rampur Jaunpur School: Shree Adarsh Hanumant inter collage
City: Mariahu City: Jaunpur
English %: 80 Board Roll No./Seat No.:
Aggregate Percentage: 79 School/College Code:
  Address of School/College: Kathwatiya prithvipur
  Centre code:
  Pin: 222203
  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 ?: Full time study
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Yes
Why do you wish to join TMI?: Best institute for BSC nautical science and good placement in this collage
What are your hobbies?: Playing crickets, see movie and travelling and reading books
What are your strengths?: I am hard working and discipline boy
What are your weaknesses?: Get nervous when talk to stranger
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 ________________