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: DNS2050111 Name: Nachiket Purohit
  Address: A 702 Wembley Estate Rosewood City
Telephone No.: Mobile no: 7990866110
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 305199130
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2050111 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: DNS2050111
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Nachiket Purohit
Mother's Name: Bansi Purohit
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Sep 2001 Nationality: Indian
Place of Birth: Jamnagar Personal Identification Mark: None
Blood Group: A + Address for Communication: A 702 Wembley Estate Rosewood City
State: Haryana Country: India
Pin: 122001 City/District: Gurugram
Mobile no: 7990866110 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Haresh Kumar Purohit Relationship with candidate: father
Parents Date of Birth: 05 Feb 1966 Parent's/Guardian's Occupation/Designation: Electrical Engineer/Senior Manager
Office Address:
Address: BPTP Centra One Golf Course Ext Rd, Baharampur Naya, Sector 61, Ghata, Haryana 122102
Country: India State: Haryana
City/District: Gurugram Pin: 122102
Tel: Mobile no.: 9810342326
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: Summer Fields School School: Summer Fields School
City: Gurugram City: Gurugram
English %: 66 Board Roll No./Seat No.: 2631296
Aggregate Percentage: 66 School/College Code: 04198
  Centre code: 2079
  Address of School/College: Dlf Qutub Enclave, Phase I, Block A, Sector 26A, Gurugram, Haryana
  Pin: 122001
  Contact Nos:
  Aggregate Percentage: 70
Details of Marks Secured in (10+2) Examination -

Physics 100 71 71
Chemistry 100 74 74
Mathematics 100 44 44
Physics, Chemistry & Mathematics combined Percentage: 63
English 100 70 70
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Me being improvement student in math I used the year to make my self physically fit by weight training and regular running
Why do you wish to join TMI?: TMI being one of the largest maritime institute to provide degree in nautical science TMI also has Excellent pacment record and is GRADED A1 by dg shipping
What are your hobbies?: Weight Training,Table Tennis and listening to music.
What are your strengths?: Mentally and Emotionally Tough
What are your weaknesses?: Lack Public speaking
How do you intend to meet the expenses of this program?: Own Resources
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

I hereby declare that all the statements made above are true and correct.

Signature of Candidate



Date ________________

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