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: DNS2051973 Name: Nikhil
Telephone No.: Mobile no: 7082940541
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 309892639
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051973 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: DNS2051973
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Nikhil
Mother's Name: Suman lata
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 26 Aug 2001 Nationality: Indian
Place of Birth: Rohtak Personal Identification Mark: Mark on forhead
Blood Group: O - Address for Communication: H.NO-157,DEV COLONY,ROHTAK H.NO-157,DEV COLONY,ROHTAK
State: Haryana Country: India
Pin: 124001 City/District: Rohtak
Mobile no: 7082940541 Telephone No. with STD code:
Aadhar Card No:552704615594 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Suman lata Relationship with candidate: Mother
Parents Date of Birth: 01 Sep 1971 Parent's/Guardian's Occupation/Designation: Professor
Office Address:
Address: Kila Road,Rohtak Kila Road,Rohtak
Country: India State: Haryana
City/District: Rohtak Pin: 124001
Tel: Mobile no.: 9416494948
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: U.C.S School: R.P.S
City: Rohtak City: Mohindergarh
English %: 76 Board Roll No./Seat No.: 2666449
Aggregate Percentage: 70 School/College Code: 530286
  Centre code: 530765
  Address of School/College: Khatod, Mohindergarh
  Pin: 123028
  Contact Nos:
  Aggregate Percentage: 91
Details of Marks Secured in (10+2) Examination -

Physics 100 81 81
Chemistry 100 95 95
Mathematics 100 95 95
Physics, Chemistry & Mathematics combined Percentage: 90.33
English 100 86 86
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: I will prepare for the interview and imucet exam
Why do you wish to join TMI?: I want to join TMI. Because it is one the most reputed institute around the globe and think i will be able to learn a great deal of things by studying in this campus
What are your hobbies?: Collecting foreign currency
What are your strengths?: Good at making new friends, And Easily adjusts with new surroundings
What are your weaknesses?: Gets sad when some close one lies
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 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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