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: Ashutosh Sharma
Mother's Name: Sneh Lata
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 05 Nov 2002 Nationality: Indian
Place of Birth: FARRUKHABAD Personal Identification Mark: Red mole on left face
Blood Group: AB +  
Date of Birth (DD/MM/YY): 05 Nov 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: Sanauda Ishwari Post - Dhirpur District- Farrukhabad , 209743
State: Uttar Pradesh Country: India
Pin: 209743 City/District: FARRUKHABAD
Mobile no: 9076627358 Telephone No. with STD code:
Aadhar Card No:657061021606 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Sneh Lata Relationship with candidate: Yes
Parents Date of Birth: 15 Dec 1982 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: Sanauda Ishwari Post - Dhirpur District- Farrukhabad , 209743
Country: India State: Uttar Pradesh
City/District: FARRUKHABAD Pin: 209743
Tel: Mobile no.: 9076627358
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Uttar Pradesh Board: Uttar Pradesh
School: Sanic GHUSUPUR School: BSS inter college
City: Mainpuri City: Kanpur
English %: 90 Board Roll No./Seat No.: 0985363
Aggregate Percentage: 75 School/College Code: 1015
  Address of School/College: Kakadeo, Kanpur,Uttar Pradesh
  Centre code: 03802
  Pin: 209743
  Contact Nos: 09076627358
  Aggregate Percentage: 60
Details of Marks Secured in (10+2) Examination -

Physics 100 51 51
Chemistry 100 65 65
Mathematics 100 51 51
Physics, Chemistry & Mathematics combined Percentage: 55.67
English 100 58 58
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
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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