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


  Dossier ID: DNS2170946
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Mohammad Farhan
Mother's Name: Sartaj khatoon
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 28 Oct 2003 Nationality: Indian
Place of Birth: Kanpur Personal Identification Mark: Slight cut in the upper lip
Blood Group: A + Address for Communication: 166 savitri nagar, sanigawan road, kanpur 166 savitri nagar,sanigawan road,kanpur
State: Uttar Pradesh Country: India
Pin: 208021 City/District: Kanpur
Mobile no: 9555568694 Telephone No. with STD code: 9555568694
Aadhar Card No:970881468053 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Mohammad Imran Relationship with candidate: Father
Parents Date of Birth: 10 Jun 1995 Parent's/Guardian's Occupation/Designation: Government servant
Office Address:
Address: 166 savitri nagar, sanigawan road, kanpur 166 savitri nagar,sanigawan road,kanpur
Country: India State: Uttar Pradesh
City/District: Kanpur Pin: 208021
Tel: 9838607032 Mobile no.: 9838607032
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: ISCE
School: Guru har Rai academy School: Guru har Rai academy
City: Kanpur City: Kanpur
English %: 69 Board Roll No./Seat No.: 6676055/015
Aggregate Percentage: 84 School/College Code: UP129
  Centre code: 2201720
  Address of School/College: Sanigawan Rd, near Rama Devi, Daheli Sujanpur, Kanpur, Uttar Pradesh
  Pin: 208021
  Contact Nos:
  Aggregate Percentage: 88
Details of Marks Secured in (10+2) Examination -

Physics 100 95 95
Chemistry 100 88 88
Mathematics 100 94 94
Physics, Chemistry & Mathematics combined Percentage: 92.33
English 100 65 65
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
11/2019 Volleyball State level Not secured
How do you intend spending your time after completing class XII Final exams and before joining college ?: I had started preparing for my competitive exams.
Why do you wish to join TMI?: Because it is one of the biggest company in shipping line and good placement giving company.
What are your hobbies?: Exercising and health care.
What are your strengths?: My greatest strength is my friendly nature with the person and I think it is good in ship.
What are your weaknesses?: I think I am not so fluent in English but I am working on it.
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 ________________

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