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: DNS2052509 Name: Ganpat hasmukhbhai parmar
  Address: Near dhrol gate Jodiya
Telephone No.: Mobile no: 9265802214
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 311687576
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052509 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: DNS2052509
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Ganpat hasmukhbhai parmar
Mother's Name: Bhavnaben parmar
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 28 Oct 2001 Nationality: Indian
Place of Birth: Jamnagar Personal Identification Mark: On stomach
Blood Group: A + Address for Communication: Near dhrol gate Jodiya
State: Gujarat Country: India
Pin: 361250 City/District: Jamnagar
Mobile no: 9265802214 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Hasmukhbhai parmar Relationship with candidate: Father
Parents Date of Birth: 26 Jul 1976 Parent's/Guardian's Occupation/Designation: Govt employee
Office Address:
Address: GSRTC DEPOT Bus stand road
Country: India State: Gujarat
City/District: Jamnagar Pin: 361001
Tel: Mobile no.: 9429141513
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: Sainik school balachadi School: Sainik school balachadi
City: Jamnagar City: Jamnagar
English %: 90 Board Roll No./Seat No.: 1608546
Aggregate Percentage: 76 School/College Code: 03052
  Centre code: 1044
  Address of School/College: Sainik school balachadi, jamnagar.
  Pin: 361230
  Contact Nos:
  Aggregate Percentage: 67
Details of Marks Secured in (10+2) Examination -

Physics 100 65 65
Chemistry 100 69 69
Mathematics 100 45 45
Physics, Chemistry & Mathematics combined Percentage: 59.67
English 100 71 71
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
01/2013 Poem recitation School level First
10/2018 Debate competition School level First
07/2017 NCC A certificate National level Grade B
Vocational and Training Courses undertaken:
11/2016 Annual training camp NCC 10 days
10/2017 Annual training camp NCC 10 days
How do you intend spending your time after completing class XII Final exams and before joining college ?: Just preparing for my engineering entrance exam and giving time to my self and my hobbies.
Why do you wish to join TMI?: I think the organisation will provide me a proper guidance to achieve my goal.
What are your hobbies?: 1. Meditation, making soil painting and playing table tennis.
What are your strengths?: A good public speaker
What are your weaknesses?: Laziness
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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