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: Amrit Raj
Mother's Name: Nibha Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Dec 2001 Nationality: Indian
Place of Birth: Arrah Personal Identification Mark: Birthmark
Blood Group: AB +  
Date of Birth (DD/MM/YY): 01 Dec 2001 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: Kamla sadan, Bans kothi bengalia akhada near bengalia akhada at macchuatoli
State: Bihar Country: India
Pin: 800004 City/District: Patna
Mobile no: 9693543268 Telephone No. with STD code:
Aadhar Card No:464236946043 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Anil Kumar Relationship with candidate: Father
Parents Date of Birth: 12 Apr 1974 Parent's/Guardian's Occupation/Designation: Buisness Man
Office Address:
Address: Kamla sadan bans kothi bengalia akhada near bengalia akhada at macchuatoli
Country: India State: Bihar
City/District: Patna Pin: 800004
Tel: Mobile no.: 7992337529
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: DR D Y Patil Pushapalata Patil International school Patna School: Dr D Y PATIL Pushapalata Patil international school
City: Patna City: Patna
English %: 89 Board Roll No./Seat No.: 22662010
Aggregate Percentage: 90 School/College Code: 65666
  Address of School/College: Jaganpura Road, Brahmpur, New Bypass Kankarbagh, Patna-800027
  Centre code:
  Pin: 800027
  Contact Nos: 9693193322
  Aggregate Percentage: 99
Details of Marks Secured in (10+2) Examination -

Physics 100 71 71
Chemistry 100 82 82
Mathematics 100 79 79
Physics, Chemistry & Mathematics combined Percentage: 77.33
English 100 92 92
IMU CET Application Number: 6004289  
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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