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: Md Tauqir Alam
Mother's Name: Sabina Khatun
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 07 Jun 2002 Nationality: Indian
Place of Birth: West Bengal Personal Identification Mark: Cut on left hand at thumb
Blood Group: A +  
Date of Birth (DD/MM/YY): 07 Jun 2002 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: India,West Bengal, Siliguri, Latpanchor, Pravat Tole India,West Bengal, Siliguri, Latpanchor, Pravat Tole IndiaWest Bengal, Siliguri, Latpanchor, Pravat Tole
State: West Bengal Country: India
Pin: 734008 City/District: Darjeeling
Mobile no: 7718662147 Telephone No. with STD code: 7718662147
Aadhar Card No:287710480888 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Md Afzal Hussain Relationship with candidate: Father
Parents Date of Birth: 17 Feb 1973 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: India,West Bengal, Siliguri, Latpanchor, Pravat Tole India,West Bengal, Siliguri, Latpanchor, Pravat Tole India,West Bengal, Siliguri, Latpanchor, Pravat Tole
Country: India State: West Bengal
City/District: Darjeeling Pin: 734008
Tel: 07718662147 Mobile no.: 7718662147
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Sai Sundaram School School: Air Force School Bagdogra
City: Siliguri City: Siliguri
English %: 92 Board Roll No./Seat No.:
Aggregate Percentage: 82 School/College Code:
  Address of School/College: West Bengal, Siliguri, Bagdogra, Air Port
  Centre code:
  Pin: 734008
  Contact Nos: 7718662147
  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 ?: I will prepare for sponsorship exam, test, and interview Second thing i will prepare for IMUCET exam.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: I applied for dns which is about 12 months course. In my opinion this is the best course because in less time we achieve many things.
Why do you wish to join TMI?: I wish to join TMI because it has good placement and almost every companies used to visit this institute.
What are your hobbies?: My hobby is to play chess.
What are your strengths?: My strength is that I am able to control my anger.
What are your weaknesses?: My weakness is that I am not fluent in English language but I am working on it.
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 ________________

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