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: DEG2184869
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Ashutosh Chauhan
Mother's Name: Kumari Anuradha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Nov 2003 Nationality: Indian
Place of Birth: Hamirpur Personal Identification Mark: mole on right side of neck
Blood Group: A +  
Date of Birth (DD/MM/YY): 12 Nov 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: Village Kothi Post Office Town Bharari Devi tehsil and district Hamirpur, Himachal Pradesh
State: Himachal Pradesh Country: India
Pin: 176041 City/District: Hamirpur
Mobile no: 8091216002 Telephone No. with STD code:
Aadhar Card No:3112293495693 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Vipan Kumar Relationship with candidate: Father
Parents Date of Birth: 10 Jul 1966 Parent's/Guardian's Occupation/Designation: Principal
Office Address:
Address: Govt. Sr. Sec. School, Amlehar Nadaun, Hamirpur
Country: India State: Himachal Pradesh
City/District: Hamirpur Pin: 177033
Tel: Mobile no.: 8219177473
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: DAV Public School Hamirpur. School: HAPS Vikas Nagar
City: Hamirpur City: Hamirpur
English %: 87 Board Roll No./Seat No.:
Aggregate Percentage: 84 School/College Code:
  Address of School/College: Vikasnagar Salasi Hamirpur
  Centre code:
  Pin: 177001
  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
07/2018 NCC Cadet JD
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for upcoming Entrance Exams and muscle workout
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: It seems to be good option for me because i like traveling and its a adventurous profession which suits my personality
Why do you wish to join TMI?: I wish to join TMI because it is one of top rated institution in India.
What are your hobbies?: Gym, Cricket, Chess
What are your strengths?: Muscular body and sharp mind
What are your weaknesses?: I trust people easily.
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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