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: DNS2052185 Name: Akash kumar
  Address: Vill bhojapur Dist ghazipur
Telephone No.: Mobile no: 9330449919
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 282.6 (Includes Convenience fee of ₹ 82.6 ) DD Number: -
Issuing Bank: - Transaction Id: 310383372
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052185 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: DNS2052185
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Akash kumar
Mother's Name: Kusum Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 Nov 2001 Nationality: Indian
Place of Birth: Uttarprades Personal Identification Mark: A mole on forehead
Blood Group: B + Address for Communication: Vill bhojapur Dist ghazipur
State: Uttar Pradesh Country: India
Pin: 233226 City/District: Ghazipur
Mobile no: 9330449919 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Feku ram Relationship with candidate: Father
Parents Date of Birth: 01 Oct 1970 Parent's/Guardian's Occupation/Designation: Government employee
Office Address:
Address: Airport authority of India Dumdum, kolkata
Country: India State: West Bengal
City/District: Kolkata Pin: 700052
Tel: Mobile no.: 8420969620
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Kendriya vidyalaya koliwada School: Kendriya vidyalaya O.F. Dumdum kolkata
City: Mumbai City: Kolkata
English %: 80 Board Roll No./Seat No.:
Aggregate Percentage: 80 School/College Code:
  Centre code:
  Address of School/College: Jessore road ,dumdum kolkata
  Pin: 700028
  Contact Nos:
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: In learning new skills and want to know more about navy.
Why do you wish to join TMI?: Reputed college
What are your hobbies?: Reading books, playing games, interested in sports, video games
What are your strengths?: Hard working,sincere and humbleness.
What are your weaknesses?: Focus on one thing at a time.
How do you intend to meet the expenses of this program?: Own Resources,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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