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: DNS2052687 Name: Shreyash Gupta
  Address: 91, Vijay Nagar Kanpur Road
Telephone No.: Mobile no: 8707449436
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 312288244
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2052687 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: DNS2052687
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Shreyash Gupta
Mother's Name: Reema Gupta
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Dec 2002 Nationality: India
Place of Birth: Lucknow Personal Identification Mark: Scratch on neck
Blood Group: B + Address for Communication: 91, Vijay Nagar Kanpur Road
State: Uttar Pradesh Country: India
Pin: 226023 City/District: Lucknow
Mobile no: 8707449436 Telephone No. with STD code:
Aadhar Card No:310458973181 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Reema Gupta Relationship with candidate: Mother
Parents Date of Birth: 24 Apr 1975 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: 91, Vijay Nagar Kanpur Road
Country: India State: Uttar Pradesh
City/District: Lucknow Pin: 226023
Tel: Mobile no.: 8707259232
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Vishwanath Academy School: Vishwanath Academy
City: Lucknow City: Lucknow
English %: 93 Board Roll No./Seat No.:
Aggregate Percentage: 85 School/College Code:
  Centre code:
  Address of School/College: Sector M-1, Parag dairy road, Aashiana
  Pin: 226012
  Contact Nos: 9169388348
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
02/2020 Singing Competiton Inter school Bronze Medal
07/2019 Craft Desining out of waste Inter school Silver Medal
05/2018 Chess Competiton Inter house Third Position
10/2020 Football Competition Inter School No Medal
How do you intend spending your time after completing class XII Final exams and before joining college ?: I believe to make most out of my time. I spend my time by making entertaining videos which I upload on YouTube, playing football, learning instruments - guitar and preparing and furnishing my subjects for the upcoming exams. I suppose this is the best way one can utilise the leisure time to nourish talent and be worthwhile.
Why do you wish to join TMI?: TMI is of course a prestigious institution to seek and pursue education and overall comprehensive development which basically drew me towards it.
What are your hobbies?: My hobbies include singing, football, upload entertaining videos on YouTube and playing guitar.
What are your strengths?: I am known for my patience and contentment and i think that these are the keys to happiness and success.
What are your weaknesses?: i firmly accept my hesitation and haste as my weakness.
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 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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