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: DEG2181570
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Khan Mohammad Saud Mohd Mukeem
Mother's Name: Noor Jahan
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Dec 2003 Nationality: Indian
Place of Birth: Mumbai Personal Identification Mark: Lumps on my Chest
Blood Group: A +  
Date of Birth (DD/MM/YY): 12 Dec 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: Room No.4/A Shinde Chawl Kadam Estate R.M Road Gulshan Nagar Oshiwara Jogeshwari West
State: Maharashtra Country: India
Pin: 400102 City/District: Mumbai
Mobile no: 9967987354 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Mohd Mukeem Khan Relationship with candidate: Father
Parents Date of Birth: 01 Jan 1970 Parent's/Guardian's Occupation/Designation: Self Employed
Office Address:
Address: A1 Furniture Mart Shop No.17 Chaturvedi Compound Opposite H.P Petrol Pump S.V Road Oshiwara Jogeshwari West
Country: India State: Maharashtra
City/District: Mumbai Pin: 400102
Tel: Mobile no.: 9833722481
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: K.H.M.W High School School: Shri Kishore Mangal Murti Junior College
City: Mumbai City: Palghar
English %: 57 Board Roll No./Seat No.:
Aggregate Percentage: 68 School/College Code:
  Address of School/College: Nallasopara West Vasai , Palghar
  Centre code:
  Pin: 401209
  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 ?: I will prepare myself for better communication skills and prepare for my entrance examination.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Degree in Nautical Science is good for me because it can create opportunities for jobs as a marine engineer or navigation officer.
Why do you wish to join TMI?: Because TMI is one of best College in the field of Maritime studies in our country.
What are your hobbies?: My Hobbies are Playing Chess, Reading , Writing etc.
What are your strengths?: My strengths are Patience, Determination, Dedication.
What are your weaknesses?: Sometimes lack of confidence.
How do you intend to meet the expenses of this program?: Own Resources,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 ________________