Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science 2021)

Application Summary: Diploma in Nautical Science
Dossier ID: DNS2170875 Name: Shashank Singh
  Address: G-2434 Second Floor Sainik Colony Sector-49
Telephone No.: Mobile no: 9315233652
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 422601800
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2170875 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: DNS2170875
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Shashank Singh
Mother's Name: Kanchan Singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 May 2002 Nationality: Indian
Place of Birth: Faridabad Personal Identification Mark: Birthmark on back
Blood Group: O + Address for Communication: G-2434 Second Floor Sainik Colony Sector-49
State: Haryana Country: India
Pin: 121001 City/District: Faridabad
Mobile no: 9315233652 Telephone No. with STD code:
Aadhar Card No:809755468387 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Pankaj Singh Relationship with candidate: Father
Parents Date of Birth: 10 Jan 1976 Parent's/Guardian's Occupation/Designation: Advocate
Office Address:
Address: 215 Lawyers Chambers Sector 12
Country: India State: Haryana
City/District: Faridabad Pin: 121001
Tel: Mobile no.: 9868223630
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: DAV Public School NH-3 School: DAV Public School NH-3
City: Faridabad City: Faridabad
English %: 77 Board Roll No./Seat No.: 17609633
Aggregate Percentage: 81 School/College Code: 40241
  Centre code: 4029
  Address of School/College: KL Mehta Road, NH 3, N.I.T, Faridabad, Haryana
  Pin: 121001
  Contact Nos:
  Aggregate Percentage: 71
Details of Marks Secured in (10+2) Examination -

Physics 100 72 72
Chemistry 100 58 58
Mathematics 100 47 47
Physics, Chemistry & Mathematics combined Percentage: 59
English 100 91 91
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
09/2013 Astronomy Olympiad School and State level Gold and a Silver medal
02/2020 JEE Mains All India 87 Percentile
08/2020 NCHMCT JEE All India AIR 2720
How do you intend spending your time after completing class XII Final exams and before joining college ?: Teaching Students, Reading the books and physical activities
Why do you wish to join TMI?: Best Institute means best training and this training will play a vital role in my future prospects. For all these things I am aimed to join your Institute only
What are your hobbies?: Reading, Grasping new skills and knowledge, Sports
What are your strengths?: Creativity, Adaptability, Communication Skills, Self Improvement
What are your weaknesses?: Excessive focus, Multitasking too much
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 Class XII admit card not uploaded Class XII marksheet

I hereby declare that all the statements made above are true and correct.

Signature of Candidate



Date ________________

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