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: Latpanchor 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: 07699520686
Aadhar Card No: 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 IndiaWest 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.: 12633540
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 spend my time on my preparation for IMUCET
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: In my opinion DNS is good because in less time we achieve many more things
Why do you wish to join TMI?: It is because its placement is good and almost every companies used 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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