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: Gopal singh
Mother's Name: Vijay Laxmi Singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 07 Sep 2000 Nationality: Indian
Place of Birth: Azamgarh Personal Identification Mark: Aadhar card
Blood Group: O +  
Date of Birth (DD/MM/YY): 07 Sep 2000 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: Gangotrinagar paranapur azmgarh
State: Uttar Pradesh Country: India
Pin: 276001 City/District: azmgarh
Mobile no: 6392935729 Telephone No. with STD code:
Aadhar Card No:281146356065 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Pankaj Singh Relationship with candidate: Father
Parents Date of Birth: 07 Jul 1977 Parent's/Guardian's Occupation/Designation: businessmen
Office Address:
Address: Paranapur Azamgarh
Country: India State: Uttar Pradesh
City/District: azmgarh Pin: 276001
Tel: Mobile no.: 9453525762
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Children senior secondary school School: Children senior secondary school
City: azamgarh City: azamgarh
English %: 87 Board Roll No./Seat No.:
Aggregate Percentage: 88 School/College Code:
  Address of School/College: Belaisa azamgarh
  Centre code:
  Pin: 276001
  Contact Nos:
  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 ?: By reading book and spending time with family and friends.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: A degree in marine engineering/nautical science will provide me an exciting opportunity to choose marine engineering as a profession and will help me explore the wast feild of Nautical science and marine science
Why do you wish to join TMI?: It will provide me better guidance
What are your hobbies?: reading novels and playing games
What are your strengths?: Leadership,Confidence and communication skills
What are your weaknesses?: Try to find perfection in everything
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 ________________

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