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: Samal Spandan Babu
Mother's Name: Banita
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 25 Apr 2002 Nationality: India
Place of Birth: Mumbai Personal Identification Mark: No
Blood Group: B +  
Date of Birth (DD/MM/YY): 25 Apr 2002 Nationality: India
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : SAMAL SPANDAN BABU Passport No.: U4217567
Date of Expiry: 10 Feb 2031 Place of Issue: Mumbai
(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: Flat No-08, Bldg No-J1, Phase -1, Happinest near Eklavya High School, Kambalgaon, Betegaon Boisar East, Palghar.
State: Maharashtra Country: India
Pin: 401506 City/District: Palghar
Mobile no: 7410799938 Telephone No. with STD code: 07620614494
Aadhar Card No:520068508055 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Babu Trinath Samal Relationship with candidate: Father
Parents Date of Birth: 08 Apr 1971 Parent's/Guardian's Occupation/Designation: Job
Office Address:
Address: Plot No-G18/3, Delta Cotton LLP near Lalit Hotel, Sattar Bangla Road, MIDC, Boisar
Country: India State: Maharashtra
City/District: Palghar Pin: 401506
Tel: Mobile no.: 8806818387
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: Year of Passing:
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Details of Marks Secured in (10+2) Examination -

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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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