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: Shubham Gautam
Mother's Name: Archana Upadhyay
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 18 Sep 2000 Nationality: Indian
Place of Birth: BUNDI Personal Identification Mark: Mole on neck
Blood Group: O +  
Date of Birth (DD/MM/YY): 18 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: A-8 , Gate no.-1, Navjeevan Sangh Colony Nainwa road Bundi
State: Rajasthan Country: India
Pin: 323001 City/District: BUNDI
Mobile no: 9079631380 Telephone No. with STD code: 9079631380
Aadhar Card No:5074 9048 2894 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Vidhya Shankar Gautam Relationship with candidate: Father
Parents Date of Birth: 01 Jul 1969 Parent's/Guardian's Occupation/Designation: Teaching
Office Address:
Address: A-8 , Gate no.-1, Navjeevan Sangh Colony Nainwa road Bundi
Country: India State: Rajasthan
City/District: BUNDI Pin: 323001
Tel: Mobile no.: 9828124315
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Emmanuel Sr. Sec . School School: Emmanuel Sr Sec School
City: Bundi City: Bundi
English %: 90 Board Roll No./Seat No.: 11632180
Aggregate Percentage: 90 School/College Code: 10415
  Address of School/College: Police Line Road , Bundi
  Centre code: 1200
  Pin: 323001
  Contact Nos: 9079631380
  Aggregate Percentage: 77
Details of Marks Secured in (10+2) Examination -

Physics 100 79 79
Chemistry 100 87 87
Mathematics 100 68 68
Physics, Chemistry & Mathematics combined Percentage: 78
English 100 74 74
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: I spend this time to improve my skills and knowledge
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Job in this field is adventurous and a person has many opportunities
Why do you wish to join TMI?: It is one of the most reputed and premiun college in the field of marine education
What are your hobbies?: Swimming and shooting
What are your strengths?: Determination
What are your weaknesses?: Emotional
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 ________________

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