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:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Ujjaval Upadhyay
Mother's Name: Punam Upadhyay
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 30 Sep 2000 Nationality: Indian
Place of Birth: Nainital Personal Identification Mark: Mole near eyebrows
Blood Group: B +  
Date of Birth (DD/MM/YY): 30 Sep 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: House no.27 Stonleigh Compound Tallital , Nainital
State: Uttaranchal Country: India
Pin: 263002 City/District: Nainital
Mobile no: 9756401922 Telephone No. with STD code:
Aadhar Card No:688194968484 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Girish Upadhyay Relationship with candidate: Son
Parents Date of Birth: 10 Aug 1964 Parent's/Guardian's Occupation/Designation: Ex Army personnel
Office Address:
Address: House no.27 Stonleigh Compound Tallital , Nainital
Country: India State: Uttaranchal
City/District: Nainital Pin: 263002
Tel: Mobile no.: 8006576803
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: ISCE
School: St.Josephs College Nainital School: St.Josephs College
City: Nainital City: Nainital
English %: 79 Board Roll No./Seat No.: 6619312
Aggregate Percentage: 81 School/College Code: 012
  Address of School/College: House no.27 Stonleigh Compound Tallital , Nainital
  Centre code: 2201954
  Pin: 263002
  Contact Nos: 08006576803
  Aggregate Percentage: 90
Details of Marks Secured in (10+2) Examination -

Physics 100 92 92
Chemistry 100 88 88
Mathematics 100 81 81
Physics, Chemistry & Mathematics combined Percentage: 87
English 100 89 89
IMU CET Application Number: 360352  
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
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 ________________

Print Summary and Application Form