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: DNS2174343 Name: HIMANSHU SINGH
Telephone No.: Mobile no: 7270999800
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425755477
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2174343 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: DNS2174343
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: HIMANSHU SINGH
Mother's Name: NILAM DEVI
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 18 Jan 2002 Nationality: INDIAN
Place of Birth: AZAMGARH Personal Identification Mark: A MOLE ON FACE
Blood Group: O + Address for Communication: BIRBHANPUR,MEHNAGAR AZAMGARH,U.P, INDIA 276204
State: Uttar Pradesh Country: India
Pin: 276204 City/District: AZAMGARH
Mobile no: 7270999800 Telephone No. with STD code:
Aadhar Card No:409454719645 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: YASHVANT SINGH Relationship with candidate: FATHER
Parents Date of Birth: 01 Jan 1967 Parent's/Guardian's Occupation/Designation: FARMER
Office Address:
Address: Birbhanpur ,Mehnagar AZAMGARH,U.P, INDIA 276204
Country: India State: Uttar Pradesh
City/District: AZAMGARH Pin: 276204
Tel: 99800 Mobile no.: 9670885428
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Uttar Pradesh Board: Uttar Pradesh
School: S.S INTER COLLEGE School: S.C.B.P.I.C
English %: 74 Board Roll No./Seat No.: 1690154
Aggregate Percentage: 73 School/College Code: 1292
  Centre code: 06808
  Address of School/College: ANEI,JAHANAGANJ,AZAMGARH
  Pin: 276131
  Contact Nos:
  Aggregate Percentage: 61
Details of Marks Secured in (10+2) Examination -

Physics 100 63 63
Chemistry 100 56 56
Mathematics 100 70 70
Physics, Chemistry & Mathematics combined Percentage: 63
English 100 60 60
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Traveling
Why do you wish to join TMI?: I want to join TMI as it is best institute in India or even in Asia for marine studies
What are your hobbies?: Farming and playing chees
What are your strengths?: Leadership and Teamworking
What are your weaknesses?: avoiding negative word like failure or inept
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

I hereby declare that all the statements made above are true and correct.

Signature of Candidate



Date ________________

Print Summary and Application Form