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: Vaibhav khare
Mother's Name: Jyoti khare
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 27 Nov 2003 Nationality: Indian
Place of Birth: Chitrakoot Personal Identification Mark: None
Blood Group: B +  
Date of Birth (DD/MM/YY): 27 Nov 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: Behind bindiram hotel ranipur bhatt chitrakoot Purani bazar karwi
State: Uttar Pradesh Country: India
Pin: 210205 City/District: Chitrakoot
Mobile no: 9838536705 Telephone No. with STD code:
Aadhar Card No:494398978786 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Jitendra khare Relationship with candidate: Father
Parents Date of Birth: 21 Feb 1978 Parent's/Guardian's Occupation/Designation: Accountant
Office Address:
Address: Bus stand karwi Bus stand karwi chitrakoot
Country: India State: Uttar Pradesh
City/District: Chitrakoot Pin: 210205
Tel: Mobile no.: 8840156018
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: St.thomas School: St.thomas
City: Chitrakoot City: Chitrakoot
English %: 91 Board Roll No./Seat No.:
Aggregate Percentage: 95 School/College Code:
  Address of School/College: Kutaha road shivrampur chitrakoot
  Centre code:
  Pin: 210205
  Contact Nos: 08840156018
  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 ?: Playing volleyball
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Yes
Why do you wish to join TMI?: Because i have a keen interest in working between machines and travelling
What are your hobbies?: Volleyball , reading and listening music
What are your strengths?: I am very cool minded and calm
What are your weaknesses?: Attached to family
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 ________________

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