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: Amit Verma
Mother's Name: Kamla wati
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 06 Oct 2003 Nationality: Indian
Place of Birth: Ghaziabad Personal Identification Mark: No
Blood Group: A +  
Date of Birth (DD/MM/YY): 06 Oct 2003 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Amit Verma Passport No.: V0736175
Date of Expiry: 28 Jun 2031 Place of Issue: Ghaziabad
(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: House no 205 Gali no 04 Adarsh Colony Bihari Pura
State: Uttar Pradesh Country: India
Pin: 201009 City/District: Ghaziabad
Mobile no: 7838096356 Telephone No. with STD code:
Aadhar Card No:561331315443 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Rajesh Verma Relationship with candidate: Father
Parents Date of Birth: 01 Jan 1981 Parent's/Guardian's Occupation/Designation: Plumber
Office Address:
Address: House no 205 Gali no 04 Adarsh colony bihari pura
Country: India State: Uttar Pradesh
City/District: GHAZIABAD Pin: 201009
Tel: Mobile no.: 7838096356
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: EAST DELHI PUBLIC SCHOOL School: Dr Durgabai Deshmukh Memorial Senior Secondary School
City: Ghaziabad City: New Delhi
English %: 65 Board Roll No./Seat No.: 26646427
Aggregate Percentage: 71 School/College Code: 87042
  Address of School/College: 1,Deen Dayal Upadhyay Marg ITO,New Delhi 110002
  Centre code:
  Pin: 110002
  Contact Nos: 01123232662
  Aggregate Percentage: 70
Details of Marks Secured in (10+2) Examination -

Physics 100 74 74
Chemistry 100 58 58
Mathematics 100 78 78
Physics, Chemistry & Mathematics combined Percentage: 70
English 100 67 67
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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