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: Aftab Ansari
Mother's Name: Anjum Nisha
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 05 Jan 2004 Nationality: India
Place of Birth: Sisai Personal Identification Mark: Mole on right leg
Blood Group: O +  
Date of Birth (DD/MM/YY): 05 Jan 2004 Nationality: India
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: Chharda road Sisai, Gumla, Jharkhand Hazi chowk, Simalya, Ranchi, Jharkhand
State: Jharkhand Country: India
Pin: 835324 City/District: Gumla
Mobile no: 7079658411 Telephone No. with STD code:
Aadhar Card No:895665018630 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Samir Ansari Relationship with candidate: Father
Parents Date of Birth: 01 Mar 1970 Parent's/Guardian's Occupation/Designation: Business Man
Office Address:
Address: Chharda road Sisai, Gumla, jharkhand Hazi chowk, Simalya, Ranchi, Jharkhand
Country: India State: Jharkhand
City/District: Gumla Pin: 835324
Tel: Mobile no.: 7079658411
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Jharkand
School: Lady K C Roy Memorial School School: Marwari Collage Ranchi
City: Ranchi City: Ranchi
English %: 78 Board Roll No./Seat No.:
Aggregate Percentage: 74 School/College Code:
  Address of School/College: Lake road, Hindpiri, Ranchi, Jharkhand
  Centre code:
  Pin: 825222
  Contact Nos: 07079658411
  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 ________________

Print Summary and Application Form