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: Abdur Raheem Khan
Mother's Name: Noor saba
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 Jul 2002 Nationality: Indian
Place of Birth: Jaunpur Personal Identification Mark: Cut on hand
Blood Group: B +  
Date of Birth (DD/MM/YY): 15 Jul 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: Bhurkurhan Manikalan Jaunpur Uttar Pradesh
State: Uttar Pradesh Country: India
Pin: 222139 City/District: Jaunpur
Mobile no: 8808179666 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Azeem Khan Relationship with candidate: Brother
Parents Date of Birth: 20 Aug 1990 Parent's/Guardian's Occupation/Designation: Job
Office Address:
Address: C - wing phoenix House Unit 5th Floor S B P Marg lower Parel West
Country: India State: Maharashtra
City/District: Mumbai Pin: 400013
Tel: Mobile no.: 9807528746
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Shahana International School School: Moder Ayesha Children Academy
City: Jaunpur City: Jaunpur
English %: 79 Board Roll No./Seat No.:
Aggregate Percentage: 76 School/College Code:
  Address of School/College: Sipah Jaunpur
  Centre code:
  Pin: 222142
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
11/2016 Cricket School level 2nd
30/12/2020 Slow cycling School 2nd
13/11/2019 Shot put School 3rd
13/11/2018 Shot put School 1st
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparation for IMUCET and TMI entrance exam
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because mathematics is good
Why do you wish to join TMI?: Because TMI is best in academic
What are your hobbies?: Playing cricket and volleyball
What are your strengths?: Handle the situation easily
What are your weaknesses?: Got irritate with own problem
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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