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


  Dossier ID: DNS2170868
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Shailendra Singh
Mother's Name: Rambha Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Jan 2003 Nationality: Indian
Place of Birth: Deoria Personal Identification Mark: Mole on Nose
Blood Group: B + Address for Communication: Vill. - Bhaluani Post -Bhaluani
State: Uttar Pradesh Country: India
Pin: 274182 City/District: Deoria
Mobile no: 8303235785 Telephone No. with STD code: 8303235785
Aadhar Card No:736393620255 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Janmejay Singh Relationship with candidate: Father Son
Parents Date of Birth: 05 Apr 1973 Parent's/Guardian's Occupation/Designation: Agriculture
Office Address:
Address: Vill. - Bhaluani Post- Bhaluani
Country: India State: Uttar Pradesh
City/District: Deoria Pin: 274182
Tel: 08052261899 Mobile no.: 8795615835
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Uttar Pradesh Board: Uttar Pradesh
School: SKSSIC Bhaluani Deoria School: ANSSIC Shivdhariya Bhaluani
City: Deoria City: Deoria
English %: 85 Board Roll No./Seat No.: 2536110
Aggregate Percentage: 77 School/College Code: 1119
  Centre code: 21142
  Address of School/College: Vill. - Bhaluani
  Pin: 274182
  Contact Nos: 8303235785
  Aggregate Percentage: 73
Details of Marks Secured in (10+2) Examination -

Physics 100 76 76
Chemistry 100 77 77
Mathematics 100 48 48
Physics, Chemistry & Mathematics combined Percentage: 67
English 100 75 75
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Attend a career counselling session
Why do you wish to join TMI?: Because of its behavior towards students is very good.TMI has good record for placement.
What are your hobbies?: Helping others, playing outdoor games, reading books
What are your strengths?: Patience, Respectfulness, Determination, Responsible
What are your weaknesses?: Honesty, Self improvement, Emotional Quotient
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan
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.