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: DNS2170897 Name: Nikhil Singh
  Address: Rahimabad Sarojini nagar
Telephone No.: Mobile no: 8808080824
Application fee payment details:  
Payment Status: Offline Payment Mode: Offline
Amount: DD Number: -
Issuing Bank: - Transaction Id: -
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2170897 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: DNS2170897
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Nikhil Singh
Mother's Name: Asha yadav
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 04 Jun 2003 Nationality: Indian
Place of Birth: Lucknow Personal Identification Mark: Have a eyebrow cut mark on right side
Blood Group: B + Address for Communication: Rahimabad Sarojini nagar
State: Uttar Pradesh Country: India
Pin: 226002 City/District: Lucknow
Mobile no: 8808080824 Telephone No. with STD code:
Aadhar Card No:815862554723 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Narendra Singh Relationship with candidate: Father
Parents Date of Birth: 01 Apr 1973 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: Transport nagar Kanpur road
Country: India State: Uttar Pradesh
City/District: Lucknow Pin: 226008
Tel: Mobile no.: 9415798084
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Lucknow Public School School: Lucknow Public School
City: Lucknow City: Lucknow
English %: 90 Board Roll No./Seat No.:
Aggregate Percentage: 92 School/College Code:
  Centre code:
  Address of School/College: Sector D Lda colony kanpur road lucknow
  Pin: 226012
  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 ?: By increasing my fitness level and being persistance towards my goal
Why do you wish to join TMI?: As i have been told by many people that it has the best facility and learning environment
What are your hobbies?: Volleyball , drawing , doing adventure
What are your strengths?: Never leave my work incomplete , concentrating at one thing at a time
What are your weaknesses?: I am little bit introvert
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 not uploaded 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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