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: Ashlesh nayak
Mother's Name: Jyothi nayak
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Nov 2003 Nationality: Indian
Place of Birth: Manipal Personal Identification Mark: Manipal
Blood Group: O +  
Date of Birth (DD/MM/YY): 01 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: 4-77 T/3 srinivasa nagara kajaraguttu VTC Anjaru hiriadka post
State: Karnataka Country: India
Pin: 576113 City/District: Manipal
Mobile no: 8073800150 Telephone No. with STD code: +91 8073800150
Aadhar Card No:285601899074 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Prashanth nayak Relationship with candidate: Father
Parents Date of Birth: 01 Jan 1971 Parent's/Guardian's Occupation/Designation: Farmer
Office Address:
Address: Srinivasa Nagara Kajarguttu Hiriyadka post 576113 udupi district and taluk
Country: India State: Karnataka
City/District: udupi Pin: 576113
Tel: 9448547669 Mobile no.: 9448547669
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Karnataka Board: Karnataka
School: Parkala eng med highschool School: SR pre university college
City: Manipal City: Hebri
English %: 94 Board Roll No./Seat No.:
Aggregate Percentage: 89 School/College Code:
  Address of School/College: SR pre university college kinnigudde hebri 576112 hebri tq udupi dist
  Centre code:
  Pin: 576112
  Contact Nos: 9448724251
  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 ?: 2 months
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: yes
Why do you wish to join TMI?: Good campus and top level teaching
What are your hobbies?: Playing games
What are your strengths?: Games
What are your weaknesses?: singing
How do you intend to meet the expenses of this program?: Bank Loan
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 ________________