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: Rohan Hentry
Mother's Name: Elza Sharin
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 04 Apr 2003 Nationality: Indian
Place of Birth: Ernakulam Personal Identification Mark: Mole on right middle finger
Blood Group: B +  
Date of Birth (DD/MM/YY): 04 Apr 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: Ayathuparambil h Raman Kartha Road Cheranallur
State: Kerala Country: India
Pin: 682034 City/District: Cochin
Mobile no: 9895067186 Telephone No. with STD code: 09895067186
Aadhar Card No:684034659474 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Clifin Hentry Relationship with candidate: Father
Parents Date of Birth: 12 Mar 1972 Parent's/Guardian's Occupation/Designation: Ex service
Office Address:
Address: Ayathuparambil h Raman Kartha Road Cheranallur
Country: India State: Kerala
City/District: Cochin Pin: 682034
Tel: 09895067186 Mobile no.: 9895067186
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
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Details of Marks Secured in (10+2) Examination -

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IMU CET Application Number:  
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 ________________

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