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: DNS2052527 Name: Rewale harshadeep nivruti
  Address: House no.224 Hutatma smarak jintur
Telephone No.: Mobile no: 7796313677
Application fee payment details:  
Payment Status: failure Payment Mode: Online
Amount: ₹ 200 DD Number: -
Issuing Bank: - Transaction Id: 312692015
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052527 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: DNS2052527
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Rewale harshadeep nivruti
Mother's Name: Sadhanabai
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 26 Jan 2000 Nationality: Indian
Place of Birth: Parbhani Personal Identification Mark: Student
Blood Group: A - Address for Communication: House no.224 Hutatma smarak jintur
State: Maharashtra Country: India
Pin: 431401 City/District: Parbhani
Mobile no: 7796313677 Telephone No. with STD code:
Aadhar Card No:546354121789 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Sadhana babulal pajai Relationship with candidate: Mother
Parents Date of Birth: 01 Jul 1969 Parent's/Guardian's Occupation/Designation: ANM gov. Employe
Office Address:
Address: Bhogao Jintur
Country: India State: Maharashtra
City/District: Parbhani Pin: 431401
Tel: Mobile no.: 9011274825
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2015 Year of Passing: 2020
Board: Maharashtra Board: Maharashtra
School: Trimurti pawan pratishthan newasa School: Gokulnath jr. College
City: Ahmadnagar City: Hingoli
English %: 68 Board Roll No./Seat No.:
Aggregate Percentage: 75 School/College Code:
  Centre code:
  Address of School/College: Aadgao , basmat dist-hingoli
  Pin: 431513
  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 ?: Filling the forms for DNS course and preparing for it
Why do you wish to join TMI?: Because of TMI have best faculty and education
What are your hobbies?: Playing chess, traveling , listening music, photography
What are your strengths?: Discipline, patience,respectfullness and dedication
What are your weaknesses?: I can have trouble asking for help in my personal problems
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 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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