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


  Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: JASHBIR
Mother's Name: SUNITA DEVI
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 17 Dec 2001 Nationality: INDIAN
Place of Birth: MAHMOUDPUR Personal Identification Mark: MOLE ON LEFT CHEEK
Blood Group: B + Address for Communication: Devi pura II Near krishna palace hotel, Bulandshahr
State: Uttar Pradesh Country: India
Pin: 203001 City/District: Bulandshahr
Mobile no: 6284699520 Telephone No. with STD code:
Aadhar Card No:782233640204 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: SATYAPAL SINGH Relationship with candidate: FATHER
Parents Date of Birth: 15 Nov 1971 Parent's/Guardian's Occupation/Designation: ARMY
Office Address:
Address: Devi pura II Near krishna palace hotel, Bulandshahr
Country: India State: Uttar Pradesh
City/District: Bulandshahr Pin: 203001
Tel: Mobile no.: 9058029519
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Kendriya Vidyalaya School: Kendriya Vidyalaya
City: Pathankot City: Pathankot
English %: 78 Board Roll No./Seat No.: 13659382
Aggregate Percentage: 70 School/College Code: 24538
  Centre code: 2186
  Address of School/College: Kendriya Vidyalaya no 3 mamoon cantt pathankot Punjab
  Pin: 145001
  Contact Nos:
  Aggregate Percentage: 68
Details of Marks Secured in (10+2) Examination -

Physics 100 68 68
Chemistry 100 69 69
Mathematics 100 61 61
Physics, Chemistry & Mathematics combined Percentage: 66
English 100 73 73
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
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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