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: DNS2171979 Name: Adeeb Javed
  Address: Bangawan Dumariyaganj
Telephone No.: Mobile no: 7651825405
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.29 (Includes Convenience fee of ₹ 4.29 ) DD Number: -
Issuing Bank: - Transaction Id: -
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2171979 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: DNS2171979
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Adeeb Javed
Mother's Name: Jahan Ara khatoon
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 27 Nov 2001 Nationality: Indian
Place of Birth: Siddharth n Personal Identification Mark: Mole on index finger of left hand
Blood Group: AB + Address for Communication: Bangawan Dumariyaganj
State: Uttar Pradesh Country: India
Pin: 272189 City/District: Siddharth nagar
Mobile no: 7651825405 Telephone No. with STD code:
Aadhar Card No:864205103110 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Arif Javed Relationship with candidate: Brother
Parents Date of Birth: 30 Jun 1995 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: Bangawan Dumariyaganj
Country: India State: Uttar Pradesh
City/District: Siddharth nagar Pin: 272189
Tel: Mobile no.: 7905101501
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: Central Academy School: Central Academy
City: Lucknow City: Lucknow
English %: 66 Board Roll No./Seat No.: 5712428
Aggregate Percentage: 66 School/College Code: 2130918
  Centre code: 1074243
  Address of School/College: Soil height appar Pant nagar Khurram nagar
  Pin: 226022
  Contact Nos: 7651825405
  Aggregate Percentage: 72
Details of Marks Secured in (10+2) Examination -

Physics 100 70 70
Chemistry 100 51 51
Mathematics 100 79 79
Physics, Chemistry & Mathematics combined Percentage: 66.67
English 100 74 74
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
09/2018 Cricket Intermediate level Winner
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for some other courses. Then one of my friend Tell you should try in merchant navy then I fill this form.
Why do you wish to join TMI?: This is best college in india.
What are your hobbies?: Playing cricket, watching cricket match, doing physical exercise daily
What are your strengths?: My family and friends are my strengths.
What are your weaknesses?: Some time I over sleep and I am working on my habit.
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 ________________

Last date for payment of application fees has passed. No further application fee payment will be accepted.
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