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: Misty Naik
Mother's Name: Mamata Naik
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 21 Nov 2003 Nationality: Indian
Place of Birth: Baripada Personal Identification Mark: A small mole below the left eye and another mole at the root of the index finger of right hand
Blood Group: A +  
Date of Birth (DD/MM/YY): 21 Nov 2003 Nationality: Indian
Gender (M/F): Female 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: Brundavan colony Beheramal Jharsuguda
State: Orissa Country: India
Pin: 768201 City/District: Jharsuguda
Mobile no: 8260613265 Telephone No. with STD code:
Aadhar Card No:474316978534 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Ganesh Kumar Naik Relationship with candidate: Daughter
Parents Date of Birth: 14 Feb 1967 Parent's/Guardian's Occupation/Designation: Service in SBI
Office Address:
Address: State Bank of india Main branch , jharsuguda Collected road
Country: India State: Orissa
City/District: Jharsuguda Pin: 768201
Tel: Mobile no.: 9993645389
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Ghanashyam Hemlata Vidya Mandir School: Ghanashyam Hemlata Vidya Mandir
City: Jharsuguda City: Jharsuguda
English %: 77 Board Roll No./Seat No.:
Aggregate Percentage: 68 School/College Code:
  Address of School/College: Balijori, jharsuguda,odisha
  Centre code:
  Pin: 768203
  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 ?: Preparing for entrance examination for merchant Navy
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because I am very much interested in colourful job of marine engineering and I love thrill adventure
Why do you wish to join TMI?: I wanted to join TMI as it is a very reputed and best institution of marine engineering and dream institute for many
What are your hobbies?: Listening music
What are your strengths?: Always be positive and try to achieve my goals
What are your weaknesses?: No any
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 ________________