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: DEG2184481
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: GAIKWAD OM SHANKAR
Mother's Name: Seema
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 05 May 2003 Nationality: Indian
Place of Birth: Mahad Personal Identification Mark: Nothing
Blood Group: B +  
Date of Birth (DD/MM/YY): 05 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: Prabhat colony shivtej apartment Mahad Raigad
State: Maharashtra Country: India
Pin: 402301 City/District: Raigad
Mobile no: 9420666455 Telephone No. with STD code:
Aadhar Card No:433195921872 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Shankar Gaikwad Relationship with candidate: Father
Parents Date of Birth: 22 Apr 1996 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: Prabhat colony shivtej apartment Mahad Raigad
Country: India State: Maharashtra
City/District: Raigad Pin: 402301
Tel: Mobile no.: 9011252052
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: Samartha Ramdas Vidalaya School: Disha Public School and Jr college
City: Mahad City: wai
English %: 68 Board Roll No./Seat No.:
Aggregate Percentage: 76 School/College Code:
  Address of School/College: chawadi chowk ravivar peth wai satara
  Centre code:
  Pin: 412803
  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 ?: Nothing properly but outdoor games Indoor games like chess
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: As it suits me as per my nature I love to travel
Why do you wish to join TMI?: To complete my further studies from a reputed institution
What are your hobbies?: Playing outdoor games
What are your strengths?: Keen eyes and keen hearing
What are your weaknesses?: Anger issues
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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