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: DEG2174000
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Aayush Gautam
Mother's Name: Purnima Gautam
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 20 Nov 2003 Nationality: Indian
Place of Birth: Vrindavan Personal Identification Mark: Small burn mark on chest
Blood Group: B +  
Date of Birth (DD/MM/YY): 20 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: 72 gautam para vrindavan Near sanjay reaidensy Bikari ji police chowki
State: Uttar Pradesh Country: India
Pin: 281121 City/District: Mathura
Mobile no: 9027521316 Telephone No. with STD code:
Aadhar Card No:573638568617 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Kapil Gautam Relationship with candidate: Father
Parents Date of Birth: 20 Oct 1977 Parent's/Guardian's Occupation/Designation: Shopkeeper
Office Address:
Address: Sharma book depit Nagar palkia chauraha Vrindavan
Country: Iran State: Uttar Pradesh
City/District: Mathura Pin: 281121
Tel: Mobile no.: 9897405939
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021 (Appearing for improvement)
Board: CBSE Board: CBSE
School: Kanha makhan public school School: Kanha makhan public school
City: Vrindavan City: Vrindavan
English %: 72 Board Roll No./Seat No.:
Aggregate Percentage: 89 School/College Code:
  Address of School/College: Near keshav dham tehra link road vrindavan
  Centre code:
  Pin: 281121
  Contact Nos: 9368539924
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
04/2015 Skit save the earth Inter house 1st
11/2019 Baal mela 17th shri krishna baal mela 1st
05/2011 Mj dance competition Inter school 3rd
04/2015 Gita Saar contest 2014 2015 District level No rank
How do you intend spending your time after completing class XII Final exams and before joining college ?: By taking coaching of IMUCET exam
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Marine engineer is an good option because of skill adventure perform in life
Why do you wish to join TMI?: TMI has a great placement record and 100 percent placement guarantee it was one of best maritime institute
What are your hobbies?: Cricket , drama , dance
What are your strengths?: Ability to make friends and a jolly and learning nature is my strenth
What are your weaknesses?: Horror stories is my weakness
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 ________________