Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science )


  Dossier ID: DNS2170782
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Saurabh Kumar
Mother's Name: Kavita Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Nov 2003 Nationality: Indian
Place of Birth: Rudrapur Personal Identification Mark: Mole on left hand
Blood Group: AB + Address for Communication: D-42 Canal Colony, Udham Singh Nagar D-42 Canal Colony, Udham Singh Nagar
State: Uttaranchal Country: India
Pin: 263153 City/District: Rudrapur
Mobile no: 7895482258 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Vinod Kumar Relationship with candidate: Father
Parents Date of Birth: 10 Sep 1966 Parent's/Guardian's Occupation/Designation: Government service
Office Address:
Address: Canal Colony Canal Colony
Country: India State: Uttaranchal
City/District: Rudrapur Pin: 263153
Tel: Mobile no.: 7895482258
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Columbus Public School School: Columbus Public School
City: Rudrapur City: Rudrapur
English %: 89 Board Roll No./Seat No.:
Aggregate Percentage: 83 School/College Code:
  Centre code:
  Address of School/College: Model Colony,Bali Vihar , Rudrapur
  Pin: 263153
  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 ?: I intend spending my time after completing class XII, I will be preparing my IMUCET exam.
Why do you wish to join TMI?: I wish to join TMI because I am looking for quality education for my excellent sea career.
What are your hobbies?: Playing volleyball, playing cricket
What are your strengths?: Punctual, active,simple
What are your weaknesses?: Being too honest.
How do you intend to meet the expenses of this program?: Own Resources
Review you documents:
Birth certificate not uploaded DGS Approved Medical Fitness Certificate not uploaded Class X marksheet not uploaded 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 ________________

Last date for payment of application fees has passed. No further application fee payment will be accepted.