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: KARTIK S NANDAGAON
Mother's Name: Rohini
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 27 May 2003 Nationality: Indian
Place of Birth: Gokak Personal Identification Mark: Mole on right hand ring finger
Blood Group: O +  
Date of Birth (DD/MM/YY): 27 May 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: Rani channamma nagar 5th cross gokak Rani channamma nagar 5th cross gokak
State: Karnataka Country: India
Pin: 591307 City/District: Gokak
Mobile no: 9380579729 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Santosh S Nandagaon Relationship with candidate: Father
Parents Date of Birth: 17 Dec 1978 Parent's/Guardian's Occupation/Designation: Self employed
Office Address:
Address: Kssidc industrial area 2nd cross behind Laxmi temple Kssidc industrial area 2nd cross behind Laxmi temple
Country: India State: Karnataka
City/District: Gokak Pin: 591307
Tel: Mobile no.: 9845710902
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Karnataka
School: The forbes academy gokak falls School: Alvas pu college
City: Gokak falls City: Moodbidri
English %: 83 Board Roll No./Seat No.:
Aggregate Percentage: 76 School/College Code: SS150
  Address of School/College: Alvas pu college Moodbidri 574227 DK
  Centre code:
  Pin: 574227
  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 exams
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Yes
Why do you wish to join TMI?: It is a good reputated college
What are your hobbies?: Drawing , swimming, badminton
What are your strengths?: I am good at sports
What are your weaknesses?: Watching tv
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 ________________