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.Sc. Nautical Science
Dossier ID: DEG2187965
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Gautam Kumar Singh
Mother's Name: Punam Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 18 Mar 2001 Nationality: Indian
Place of Birth: Motihari Personal Identification Mark: A mole on forehead
Blood Group: O +  
Date of Birth (DD/MM/YY): 18 Mar 2001 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Gautam Kumar Singh 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: Vill-Bheriharwa po-Rupdih ps-Motihari district- east champaran Bihar Vill-Bheriharwa po-Rupdih ps-Motihari district- east champaran Bihar
State: Bihar Country: India
Pin: 845401 City/District: Motihari
Mobile no: 8226994001 Telephone No. with STD code:
Aadhar Card No:263786626199 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Arvind Kumar Singh Relationship with candidate: Son
Parents Date of Birth: 20 Jul 1969 Parent's/Guardian's Occupation/Designation: Farmer
Office Address:
Address: Village- Bheriharwa, po-Rupdih, ps-Motihari ,east Champaran Village- Bheriharwa, po-Rupdih, ps-Motihari ,east Champaran
Country: India State: Bihar
City/District: Motihari Pin: 845401
Tel: Mobile no.: 7210046552
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Bihar Board: Bihar
School: Mangal Seminary High School School: M.H.K College
City: Motihari City: Motihari
English %: 58 Board Roll No./Seat No.: 19010144
Aggregate Percentage: 82 School/College Code: 34006
  Address of School/College: M.H.K College Motihari EAST CHAMPARAN ,Bihar
  Centre code: 34006
  Pin: 845401
  Contact Nos:
  Aggregate Percentage: 84
Details of Marks Secured in (10+2) Examination -

Physics 100 86 86
Chemistry 100 78 78
Mathematics 100 95 95
Physics, Chemistry & Mathematics combined Percentage: 86.33
English 100 83 83
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: I want to go on a vacation with my family and friends
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: It will provide me the opportunity to learn which will be used on board, it will also enrich my personality with experience and upcoming responsibility
Why do you wish to join TMI?: It is one of best faculty, I can learn a lot
What are your hobbies?: Sketching and painting
What are your strengths?: Punctuality and problem solving
What are your weaknesses?: Biggest critic of own self
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

I hereby declare that all the statements made above are true and correct.

Signature of Candidate



Date ________________