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: DNS2173794 Name: Anish Kumar Thakur
  Address: Gurunanak Pally Lane no. 09 Ismile
Telephone No.: Mobile no: 9905685303
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425986984
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2173794 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: DNS2173794
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Anish Kumar Thakur
Mother's Name: Manisha Thakur
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 14 Jan 2002 Nationality: Indian
Place of Birth: Deoghar Personal Identification Mark: Mole on the left arm
Blood Group: B + Address for Communication: Gurunanak Pally Lane no. 09 Ismile
State: West Bengal Country: India
Pin: 713301 City/District: Asansol Paschim Bardhaman
Mobile no: 9905685303 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Manoj Kumar Thakur Relationship with candidate: Father
Parents Date of Birth: 15 Jun 1968 Parent's/Guardian's Occupation/Designation: Teaching, Assistant Teacher
Office Address:
Address: B. N. Jha Sanskrit High School Shivganga West Deoghar
Country: India State: Jharkhand
City/District: Deoghar Pin: 814112
Tel: Mobile no.: 8210981748
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2021
Board: ISCE Board: CBSE
School: St. Francis School School: S. K. P. Vidya Vihar
City: Deoghar City: Deoghar
English %: 77 Board Roll No./Seat No.:
Aggregate Percentage: 86 School/College Code:
  Centre code:
  Address of School/College: Bompass Town, B. Deoghar
  Pin: 814112
  Contact Nos:
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Prepare for sponsorship and Imu cet exam and work on physical fitness.
Why do you wish to join TMI?: I want to join TMI because it has experienced faculty members and good grades which will help me to have a bright career at sea.
What are your hobbies?: Cooking new dishes, learning interesting things from internet, gardening, playing badminton, listening music and dancing.
What are your strengths?: Positive thinking/approach, politeness, flexibility, versatile, responsible, honest.
What are your weaknesses?: Focus too much on detailing, trouble saying no, impatient when work given run beyond deadline.
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 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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