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: DEG2182691
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Jeevan B
Mother's Name: Arockya Jenefra
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Feb 2004 Nationality: Indian
Place of Birth: Kanyakumari Personal Identification Mark: Black mole at Left hand little finger
Blood Group: A +  
Date of Birth (DD/MM/YY): 10 Feb 2004 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: 12/178782/5 Selva nager,Ammapet K.N colony Selva nager, Holy Cross Ammapet
State: Tamil Nadu Country: India
Pin: 636014 City/District: Salem
Mobile no: 7094235180 Telephone No. with STD code: 07094235180
Aadhar Card No:227716114424 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: M A Bruno Relationship with candidate: Father
Parents Date of Birth: 04 May 1996 Parent's/Guardian's Occupation/Designation: Marine Engineer
Office Address:
Address: 12/178782/5 Selva nager,Ammapet K.N colony Selva nager, Holy Cross Ammapet
Country: India State: Tamil Nadu
City/District: Salem Pin: 636014
Tel: Mobile no.: 7094235180
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021 (Appearing for improvement)
Board: Tamil Nadu Board: Tamil Nadu
School: Holy Cross Matriculation Higher Secondary School School: Holy Cross Matriculation Higher Secondary School
City: Salem City: Salem
English %: 80 Board Roll No./Seat No.:
Aggregate Percentage: 72 School/College Code:
  Address of School/College: 12/178782/5 Selva nager,Ammapet K.N colony Selva nager, Holy Cross Ammapet
  Centre code:
  Pin: 636014
  Contact Nos: 07094235180
  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
02/2017 Pravesh Soapan Traning Camp Camp Scout wing
How do you intend spending your time after completing class XII Final exams and before joining college ?: I have applied for Full stack developer course through Online .
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because I like work in ships. So I was interested in joining.
Why do you wish to join TMI?: Good Institute
What are your hobbies?: Playing Football
What are your strengths?: Running
What are your weaknesses?: Nil
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 ________________