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.Tech. Marine Engineering
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: BSEB
Mother's Name: Chanchala devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Sep 2002 Nationality: Indian
Place of Birth: Pandarakh Personal Identification Mark: Right side eyebrow scratch
Blood Group: B +  
Date of Birth (DD/MM/YY): 10 Sep 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: pandarakh,patna , Bihar-803221 Pandarakh,patna, Bihar-803221
State: Bihar Country: India
Pin: 803221 City/District: Patna
Mobile no: 8102356533 Telephone No. with STD code:
Aadhar Card No:400019396252 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Kumkum Kumari Relationship with candidate: Sister
Parents Date of Birth: 01 Jan 1996 Parent's/Guardian's Occupation/Designation: Agriculture
Office Address:
Address: Pandarakh, Patna Bihar 803221 Pandarakh patna Bihar 803221
Country: India State: Bihar
City/District: Patna Pin: 803221
Tel: Mobile no.: 8102356533
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Bihar Board: Bihar
School: Punyark Vidya Mandir School: Punyark Vidya Mandir
City: Patna City: Patna
English %: 23 Board Roll No./Seat No.: 20010076
Aggregate Percentage: 57 School/College Code: 71187
  Address of School/College: Pandarakh patna, Bihar 803221
  Centre code: 17099
  Pin: 803221
  Contact Nos:
  Aggregate Percentage: 60
Details of Marks Secured in (10+2) Examination -

Physics 100 51 51
Chemistry 100 56 56
Mathematics 100 77 77
Physics, Chemistry & Mathematics combined Percentage: 61.33
English 100 76 76
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Computer training
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Marine engineering
Why do you wish to join TMI?: Sir,at present time in the best Merine time academy for m Marine engineering course in the best training faculty and placement
What are your hobbies?: Kabbadi
What are your strengths?: Self confidence
What are your weaknesses?: I am way to detailed oriented,I just want every
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 ________________

Print Summary and Application Form