Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science 2020)

Application Summary: Diploma in Nautical Science
Dossier ID: DNS2050029 Name: Ankit Kumar Mishra
  Address: Adarsh Nagar road no.3b Samastipur,Bihar
Telephone No.: Mobile no: 9199799044
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 304977365
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050029 are true and correct.
Signature of Candidate Signature of Parent/Guardian



Date ________________ Date ________________
Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science )


  Dossier ID: DNS2050029
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Ankit Kumar Mishra
Mother's Name: Brijwala Mishra
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 Jan 2002 Nationality: Indian
Place of Birth: Samastipur Personal Identification Mark: Mole on back of neck
Blood Group: B + Address for Communication: Adarsh Nagar road no.3b Samastipur,Bihar
State: Bihar Country: India
Pin: 848101 City/District: samastipur
Mobile no: 9199799044 Telephone No. with STD code:
Aadhar Card No:744643365302 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Deepak Mishra Relationship with candidate: Father
Parents Date of Birth: 15 Feb 1981 Parent's/Guardian's Occupation/Designation: Private job
Office Address:
Address: Saharsa road, maheskhunt Khagaria
Country: India State: Bihar
City/District: Khagaria Pin: 851213
Tel: Mobile no.: 9708689635
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: Holy Mission High school School: D.A.V Public School
City: Samastipur City: Samastipur
English %: 85 Board Roll No./Seat No.: 7662656
Aggregate Percentage: 93 School/College Code: 50164
  Centre code: 7178
  Address of School/College: Harpur ailoth
  Pin: 848101
  Contact Nos:
  Aggregate Percentage: 70
Details of Marks Secured in (10+2) Examination -

Physics 100 62 62
Chemistry 100 74 74
Mathematics 100 58 58
Physics, Chemistry & Mathematics combined Percentage: 64.67
English 100 66 66
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Joining vocational course
Why do you wish to join TMI?: TMI is a prestigious institution which can definitely guide me to attain quality education in the relevant field, also hope to get placed after completion of course
What are your hobbies?: My hobbies are playing handball, volleyball and watching movies
What are your strengths?: My biggest strength is positive attitude towards accepting any thing which is right. Leading team, helping others , punctuality, hard work ,caring are other strength of mine . I love to have other suggestions
What are your weaknesses?: I am of very shy nature, at times I get sluggish,
How do you intend to meet the expenses of this program?: Bank Loan
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving 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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