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.Sc. Nautical Science Course: Second Choice B.Tech. Marine Engineering
Dossier ID: DEG2198466
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Sujal Verma
Mother's Name: Poonam Verma
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 25 Dec 2003 Nationality: Indian
Place of Birth: Chhatarpur Personal Identification Mark: Little finger bend
Blood Group: B +  
Date of Birth (DD/MM/YY): 25 Dec 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: House 36 sector 6 Jankipuram extension Lucknow
State: Uttar Pradesh Country: India
Pin: 226021 City/District: Lucknow
Mobile no: 8795812184 Telephone No. with STD code:
Aadhar Card No:588776294236 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Narendra Kumar Relationship with candidate: Father
Parents Date of Birth: 30 Nov 1969 Parent's/Guardian's Occupation/Designation: Senior Bank Auditor
Office Address:
Address: House 36 sector 6 Jankipuram Extension Lucknow
Country: India State: Uttar Pradesh
City/District: Lucknow Pin: 226021
Tel: Mobile no.: 9598666636
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
City: Lucknow City: Lucknow
English %: 92 Board Roll No./Seat No.: 23680915
Aggregate Percentage: 91 School/College Code: 70978
  Address of School/College: DPS JANKIPURAM SECTOR 6 JANKIPURAM Extension
  Centre code:
  Pin: 226021
  Contact Nos:
  Aggregate Percentage: 93
Details of Marks Secured in (10+2) Examination -

Physics 100 89 89
Chemistry 100 96 96
Mathematics 100 91 91
Physics, Chemistry & Mathematics combined Percentage: 92
English 100 92 92
IMU CET Application Number: CET21U1012163  
How do you intend spending your time after completing class XII Final exams and before joining college ?: studying about the Indian stock market and reading some books
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because this course is different from others and best suits for me
Why do you wish to join TMI?: As it is one of the best institute to do marine engineering/nautical science
What are your hobbies?: Stocks / crypto / studying
What are your strengths?: I can do anything once I decide to do so
What are your weaknesses?: Shifting to other things ,trying to do many things at a time
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 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 ________________