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.Sc. Nautical Science
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Shuvam chakraborty
Mother's Name: Sikha chakraborty
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Oct 2000 Nationality: Indian
Place of Birth: Kolkata Personal Identification Mark: Birth mark on right shoulder
Blood Group: A +  
Date of Birth (DD/MM/YY): 12 Oct 2000 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: 8 milon sarani Parnasree pally behala
State: West Bengal Country: India
Pin: 700060 City/District: Kolkata
Mobile no: 6289502031 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Swapan chakraborty Relationship with candidate: Father
Parents Date of Birth: 06 Dec 1961 Parent's/Guardian's Occupation/Designation: Private
Office Address:
Address: 51 mirza galib street Park street
Country: India State: West Bengal
City/District: Kolkata Pin: 700016
Tel: Mobile no.: 9831765573
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: ISCE Board: Bihar
School: St.Joseph and marys school School: Bihard board of open schooling and examination
City: Kolkata City: Patna
English %: 68 Board Roll No./Seat No.: 1922015103
Aggregate Percentage: 59 School/College Code: CW31130311
  Address of School/College: Samastipur
  Centre code: 848101
  Pin: 848101
  Contact Nos:
  Aggregate Percentage: 67
Details of Marks Secured in (10+2) Examination -

Physics 100 60 60
Chemistry 100 72 72
Mathematics 100 65 65
Physics, Chemistry & Mathematics combined Percentage: 65.67
English 100 70 70
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Reading and writing, visiting the local unexplored places, join a hobby class
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: I love to explore and passionate
Why do you wish to join TMI?: It is a well known college
What are your hobbies?: Cricket, gymming
What are your strengths?: Creativity, flexibility, versatility
What are your weaknesses?: Too detailed oriented
How do you intend to meet the expenses of this program?: 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 ________________

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