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: Priyank kumar
Mother's Name: Sunita devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Nov 2003 Nationality: INDIAN
Place of Birth: haridwar Personal Identification Mark: Mole on neck
Blood Group: A +  
Date of Birth (DD/MM/YY): 14 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 ajitpur laksar road Post kankhal
State: Uttaranchal Country: India
Pin: 249408 City/District: Haridwar
Mobile no: 8791540032 Telephone No. with STD code:
Aadhar Card No:509413897802 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Shyam Kumar Relationship with candidate: Son
Parents Date of Birth: 20 Sep 1979 Parent's/Guardian's Occupation/Designation: Self employee
Office Address:
Address: Village ajitpur laksar road Post kankhal
Country: India State: Uttaranchal
City/District: Haridwar Pin: 249408
Tel: Mobile no.: 9927290514
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021 (Appearing for improvement)
Board: CBSE Board: CBSE
School: SM public school School: SM public school
City: Haridwar City: Haridwar
English %: 75 Board Roll No./Seat No.:
Aggregate Percentage: 88 School/College Code:
  Address of School/College: jagjeetpur laksar road
  Centre code:
  Pin: 249408
  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:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Playing cricket and learning about merchant navy and preparing IMUCET
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because of i have to join merchant navy and i think this degree gives me some technical knowledge like about engines etc..
Why do you wish to join TMI?: Because i think it is good for me
What are your hobbies?: Playing cricket
What are your strengths?: I have self confidence
What are your weaknesses?: Overconfidence
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 ________________