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.Tech. Marine Engineering
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Choudhary Karan jasaram
Mother's Name: Meena
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Feb 2003 Nationality: Hindu
Place of Birth: Rajasthan Personal Identification Mark: A mole on the forehead
Blood Group: B +  
Date of Birth (DD/MM/YY): 14 Feb 2003 Nationality: Hindu
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: 1403,Balaji crest sec-17, plot-57 Roadpali-kalamboli Maharashtra
State: Maharashtra Country: India
Pin: 410218 City/District: Raigad
Mobile no: 9987372876 Telephone No. with STD code:
Aadhar Card No:893929286868 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Jasaram bhanaji choudhary Relationship with candidate: Father
Parents Date of Birth: 05 Apr 1972 Parent's/Guardian's Occupation/Designation: Service / job
Office Address:
Address: Balaji medical and general stores Shop no. 4 , plot-5/6/7, sec-35E, proviso Complex Kharghar , Navi mumbai-410210
Country: India State: Maharashtra
City/District: Raigad Pin: 410218
Tel: Mobile no.: 9987372876
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: Prayesh marathi and english medium school School: D. G. Tatkare junior college
City: Kalamboli City: Kalamboli
English %: 051 Board Roll No./Seat No.:
Aggregate Percentage: 63 School/College Code:
  Address of School/College: Sec-5E, kalamboli, panvel, navi mumbai
  Centre code:
  Pin: 410218
  Contact Nos: 02227426388
  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 ?:
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
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 ________________

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