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.Tech. Marine Engineering
Dossier ID: DEG2186740
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: krishna shukla
Mother's Name: sonal shukla
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 18 Jan 2003 Nationality: Indian
Place of Birth: bhopal Personal Identification Mark: mole on face
Blood Group: B +  
Date of Birth (DD/MM/YY): 18 Jan 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: RACHNA NAGAR 239 rachna nagar
State: Madhya Pradesh Country: India
Pin: 462023 City/District: BHOPAL
Mobile no: 7415688014 Telephone No. with STD code: 7415688014
Aadhar Card No:656131994766 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: sudhir shukla Relationship with candidate: father
Parents Date of Birth: 15 Jul 1980 Parent's/Guardian's Occupation/Designation: business
Office Address:
Address: RACHNA NAGAR 239 rachna nagar
Country: India State: Madhya Pradesh
City/District: BHOPAL Pin: 462023
Tel: 9516732591 Mobile no.: 9516732591
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: sagar public school School: sagar public school
City: BHOPAL City: bhopal
English %: 81 Board Roll No./Seat No.: 102345555
Aggregate Percentage: 76 School/College Code: 462024
  Address of School/College: sagar public school saket nagar bhopal
  Centre code: 0123
  Pin: 462023
  Contact Nos: 7415688014
  Aggregate Percentage: 76
Details of Marks Secured in (10+2) Examination -

Physics 100 65 65
Chemistry 100 80 80
Mathematics 100 69 69
Physics, Chemistry & Mathematics combined Percentage: 71.33
English 100 88 88
IMU CET Application Number: 54836304644  
How do you intend spending your time after completing class XII Final exams and before joining college ?: studying
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: better job oppurtinity
Why do you wish to join TMI?: best institution in india
What are your hobbies?: travelling sketching
What are your strengths?: coping up with stress
What are your weaknesses?: impatient
How do you intend to meet the expenses of this program?: Bank Loan
Review you documents:
Your passport not uploaded Class X marksheet Leaving / Transfer Certificate / Birth Certificate 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 ________________