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


  Dossier ID: DNS2172535
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Mohd Asad Naseem
Mother's Name: Malika Parveen
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 11 Feb 2001 Nationality: Indian
Place of Birth: Bijnor Personal Identification Mark: Having Mole on right leg
Blood Group: B + Address for Communication: Nai Basti b-14 Bijnor Near neel kamal talkies Bijnor
State: Uttar Pradesh Country: India
Pin: 246701 City/District: Bijnor
Mobile no: 9027623846 Telephone No. with STD code: 9027623846
Aadhar Card No:997531018045 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Mohd Naseem Relationship with candidate: Father
Parents Date of Birth: 01 Jul 1970 Parent's/Guardian's Occupation/Designation: Businessman
Office Address:
Address: Nai Basti b-14 Bijnor Near neel kamal talkies Bijnor
Country: India State: Uttar Pradesh
City/District: Bijnor Pin: 246701
Tel: 7906308071 Mobile no.: 9027623846
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2016 Year of Passing: 2019
Board: CBSE Board: Chhatisgarh
School: Dayawati Dharmavira Public School School: Dayawati Dharmavira Public School
City: Bijnor City: Bijnor
English %: 72 Board Roll No./Seat No.: 5846349
Aggregate Percentage: 74 School/College Code: 99999
  Centre code: 5723
  Address of School/College: In front of Indira Park, Bijnor
  Pin: 246701
  Contact Nos: 9027623846
  Aggregate Percentage: 64
Details of Marks Secured in (10+2) Examination -

Physics 100 61 61
Chemistry 100 62 62
Mathematics 100 62 62
Physics, Chemistry & Mathematics combined Percentage: 61.67
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 ?: With friends and research about this college
Why do you wish to join TMI?: Because this is A1grade institute
What are your hobbies?: Learning new things about computer, reading books
What are your strengths?: I am always win or learn about our mistake and I am not lose
What are your weaknesses?: When I am not complete my task
How do you intend to meet the expenses of this program?: Bank Loan
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 ________________

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