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.Sc. Nautical Science Course: Second Choice B.Tech. Marine Engineering
Dossier ID: DEG2180725
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Nivedh Kumar S
Mother's Name: Priya V
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 28 Nov 2002 Nationality: Indian
Place of Birth: Aalathur Personal Identification Mark: Mole on the right side of the forehead
Blood Group: O +  
Date of Birth (DD/MM/YY): 28 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: Padinjarethara Vandazhi 2,Mudappallur Palakkad,Kerala
State: Kerala Country: India
Pin: 678705 City/District: Palakkad
Mobile no: 9207908436 Telephone No. with STD code:
Aadhar Card No:320882078881 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: P Sasikumar Relationship with candidate: Father
Parents Date of Birth: 29 Dec 1974 Parent's/Guardian's Occupation/Designation: Electrician
Office Address:
Address: Padinjarethara Vandazhi 2,Mudappallur Palakkad,Kerala
Country: India State: Kerala
City/District: Palakkad Pin: 678705
Tel: Mobile no.: 9495228436
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: Kerala
School: St.Francis school School: CVM Higher Secondary School
City: Vadakkencherry City: vandazhy
English %: 83 Board Roll No./Seat No.:
Aggregate Percentage: 76 School/College Code:
  Address of School/College: CVM Higher Secondary School, Vandazhy, Palakkad, Kerala
  Centre code:
  Pin: 678706
  Contact Nos:
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 200
Chemistry 200
Mathematics 200
Physics, Chemistry & Mathematics combined Percentage:
English 100
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
10/2019 Cricket Kerala North Zone Second
How do you intend spending your time after completing class XII Final exams and before joining college ?: Working on my fitness and undergoing cricket training.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: The joy of travelling.
Why do you wish to join TMI?: Because its one of the prestigious college and I believe it would give me all the opportunities that there is to offer.
What are your hobbies?: Playing cricket, surfing the internet, reading, videogames.
What are your strengths?: Team Player, open minded, Creative
What are your weaknesses?: Attempting to please everyone
How do you intend to meet the expenses of this program?: Own Resources
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 ________________