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: Divyansh Agarwal
Mother's Name: Shalini Agarwal
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Mar 2002 Nationality: Indian
Place of Birth: Badaun Personal Identification Mark: None
Blood Group: O + Address for Communication: 186 b Kanoon goyan bhoor Bareilly
State: Uttar Pradesh Country: India
Pin: 243003 City/District: Bareilly
Mobile no: 7500777041 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Sanjeev Agarwal Relationship with candidate: Father
Parents Date of Birth: 24 Oct 1969 Parent's/Guardian's Occupation/Designation: Private service
Office Address:
Address: 186 b kanoon goyan bhoor Bareilly
Country: India State: Uttar Pradesh
City/District: Bareilly Pin: 243003
Tel: Mobile no.: 8534039300
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Radha madhav public school School: Radha madhav public school
City: Bareilly City: Bareilly
English %: 93 Board Roll No./Seat No.: 21623972
Aggregate Percentage: 87 School/College Code: 60076
  Centre code: 6066
  Address of School/College: Green park bislapur road bareilly
  Pin: 243006
  Contact Nos:
  Aggregate Percentage: 80
Details of Marks Secured in (10+2) Examination -

Physics 100 79 79
Chemistry 100 69 69
Mathematics 100 79 79
Physics, Chemistry & Mathematics combined Percentage: 75.67
English 100 94 94
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: I try to learn something new and extra regularly
Why do you wish to join TMI?: It is one of the best college in india with great faculty.
What are your hobbies?: Playing cricket and traveling. Sometimes i cook also
What are your strengths?: I am Hardworking, punctual and determinant to my work
What are your weaknesses?: To be an officer if i replace word Weaknesses with challenge then i am always ready to accept any challenge.
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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