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


  Dossier ID: DNS2174326
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Shobhit Katiyar
Mother's Name: Sarita Katiyar
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 05 Apr 2004 Nationality: Indian
Place of Birth: Allahganj Personal Identification Mark: Two moles on the right side of chest and injury mark on right wrist
Blood Group: B + Address for Communication: 3/247 Ruchi khand 1 3/247 Ruchi khand 1
State: Uttar Pradesh Country: India
Pin: 226002 City/District: SHARDANAGAR LUCKNOW
Mobile no: 7068695593 Telephone No. with STD code: 7068695593
Aadhar Card No:611277310815 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Sarita Katiyar Relationship with candidate: Mother
Parents Date of Birth: 14 Dec 1972 Parent's/Guardian's Occupation/Designation: Housewife
Office Address:
Address: 3/247 Ruchi khand 1 3/247 Ruchi khand 1
Country: India State: Uttar Pradesh
City/District: SHARDANAGAR LUCKNOW Pin: 226002
Tel: 09935448648 Mobile no.: 9935448648
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: CBSE
School: ST. TERESAS COLLEGE School: Awadh Public school
City: Lucknow City: Lucknow
English %: 67 Board Roll No./Seat No.: 23677878
Aggregate Percentage: 66 School/College Code: 70948
  Centre code: 7204
  Address of School/College: Raibarelly Road Sharda Nagar, Rajni Khand, 1, Lucknow, Uttar Pradesh 226002
  Pin: 226002
  Contact Nos:
  Aggregate Percentage: 73
Details of Marks Secured in (10+2) Examination -

Physics 100 80 80
Chemistry 100 74 74
Mathematics 100 57 57
Physics, Chemistry & Mathematics combined Percentage: 70.33
English 100 77 77
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
04/2019 Chess School 1
11/2019 Badminton School 3
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for college entrance Taking swimming lessons Taking chess classes
Why do you wish to join TMI?: For good placement and pay scale.TMI is one of the best institute for the merchant navy and I want a bright future in this carrier so thats why I want to join TMI
What are your hobbies?: Chess
What are your strengths?: Analytical skill
What are your weaknesses?: Shyness
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 ________________

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