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: DNS2052407 Name: Akshat hegde
  Address: 168/1 Sector 55 chandigarh
Telephone No.: Mobile no: 9877020468
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: 311270347
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052407 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: DNS2052407
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Akshat hegde
Mother's Name: seema hegde
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 02 Feb 2001 Nationality: Indian
Place of Birth: Chandigarh Personal Identification Mark: Mole on right eyebrow
Blood Group: O + Address for Communication: 168/1 Sector 55 chandigarh
State: Punjab Country: India
Pin: 160055 City/District: chandigarh
Mobile no: 9877020468 Telephone No. with STD code:
Aadhar Card No:899324758669 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Ganpati hegde Relationship with candidate: Father
Parents Date of Birth: 01 Jun 1968 Parent's/Guardian's Occupation/Designation: Marketing Manager
Office Address:
Address: Plot NO. 121 Industrial area, phase 1 Panchkula
Country: India State: Haryana
City/District: Panchkula Pin: 134113
Tel: Mobile no.: 9417133661
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Manav Mangal Smart School School: Bal niketan SR model School
City: Mohali City: Chandigarh
English %: 95 Board Roll No./Seat No.:
Aggregate Percentage: 92 School/College Code:
  Centre code:
  Address of School/College: Sector 37-A
  Pin: 160036
  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 ?: Preparing for IMUCET and other competitive exams.
Why do you wish to join TMI?: Because TMI is a very reputed college and has good placement records
What are your hobbies?: Travelling and playing cricket.
What are your strengths?: Dedication and ability to learn from mistakes.
What are your weaknesses?: trouble in saying no.
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 ________________

Print Summary and Application Form