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.Sc. Nautical Science
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Goutham S Lenin
Mother's Name: Saritha G
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 04 May 2003 Nationality: Indian
Place of Birth: Kilimanoor Personal Identification Mark: Brown mark on right cheek near the ear
Blood Group: A +  
Date of Birth (DD/MM/YY): 04 May 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: Valiyavila veedu Pulimath Pulimath PO
State: Kerala Country: India
Pin: 695612 City/District: Thiruvananthapuram
Mobile no: 9947075994 Telephone No. with STD code:
Aadhar Card No:553253144653 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: VP Lenin Relationship with candidate: Father
Parents Date of Birth: 30 May 1968 Parent's/Guardian's Occupation/Designation: Agriculture
Office Address:
Address: Valiyavila veedu Pulimath Pulimath PO
Country: India State: Kerala
City/District: Thiruvananthapuram Pin: 695612
Tel: Mobile no.: 9539712971
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021 (Appearing for improvement)
Board: Kerala Board: Kerala
School: Govt.HSS kilimanoor School: Govt.HSS kilimanoor
City: Thiruvananthapuram City: Thiruvananthapuram
English %: 95 Board Roll No./Seat No.:
Aggregate Percentage: 85 School/College Code:
  Address of School/College: Govt.HSS Kilimanoor Kilimanoor PO
  Centre code:
  Pin: 695601
  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:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Appearing online crash course
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because my ambition os to become merchant navy officer.
Why do you wish to join TMI?: I have heard lot about the institute and admires the institutes growth and success.
What are your hobbies?: Reading,writting,sports
What are your strengths?: Determination, hardworking ,creativity and trustworthiness
What are your weaknesses?: Self criticism , introvert
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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