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:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Md Asfak
Mother's Name: Sahin parween
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 03 Jan 2001 Nationality: Indian
Place of Birth: Keonjhar Personal Identification Mark: None
Blood Group: B +  
Date of Birth (DD/MM/YY): 03 Jan 2001 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: Buladwarsahi Near patanjali chikitsalaya
State: Orissa Country: India
Pin: 758001 City/District: Keonjhar
Mobile no: 8917532795 Telephone No. with STD code: 08917532795
Aadhar Card No:644585822902 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Md Salaudin Relationship with candidate: Father
Parents Date of Birth: 17 Aug 1970 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: Buladwarsahi Near patanjali chikitsalaya
Country: India State: Orissa
City/District: Keonjhar Pin: 758001
Tel: 08917532795 Mobile no.: 8917532795
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: Orissa
School: Nirmala convent school School: Dharanidhar autonomous college
City: Keonjhar City: Keonjhar
English %: 72 Board Roll No./Seat No.: 315GA030
Aggregate Percentage: 79 School/College Code: 758001
  Address of School/College: Buladwarsahi Near patanjali chikitsalaya
  Centre code: 758001
  Pin: 758001
  Contact Nos: 08917532795
  Aggregate Percentage: 78
Details of Marks Secured in (10+2) Examination -

Physics 100 82 82
Chemistry 100 82 82
Mathematics 100 77 77
Physics, Chemistry & Mathematics combined Percentage: 80.33
English 100 60 60
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: I used to spend my time in playing sports, readings books and preparing fotlr imu cet
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Tolani maritime institute is a reputed institute . So, to get admission in this institute is a proud moment for me and to get educate from this institute and get a bsc degree .
Why do you wish to join TMI?: Because it is very reputed institute and has a
What are your hobbies?: Playing cricket, reading books.
What are your strengths?: I can learn from my mistake and tries to never repeat the same mistake again
What are your weaknesses?: I usually trust the any guys easily
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 ________________