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: Saksham gangwar
Mother's Name: Archana gangwar
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 03 Sep 2001 Nationality: Indian
Place of Birth: Bareilly Personal Identification Mark: Nil
Blood Group: O + Address for Communication: Singh Gautiya, baheri, UP Baheri
State: Uttar Pradesh Country: India
Pin: 243201 City/District: Bareilly
Mobile no: 8279862731 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Sanjeev gangwar Relationship with candidate: Father
Parents Date of Birth: 20 May 1979 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: Singh gautiya, baheri. Baheri
Country: India State: Uttar Pradesh
City/District: Bareilly Pin: 243201
Tel: Mobile no.: 9719833632
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: CBSE Board: CBSE
School: Bhartiyam international school School: Mission academy
City: Rudrapur City: Baheri
English %: 67 Board Roll No./Seat No.: 5644280
Aggregate Percentage: 69 School/College Code: 54304
  Centre code: 56227
  Address of School/College: Mandanpur ,Baheri,UP
  Pin: 243201
  Contact Nos: 8279862731
  Aggregate Percentage: 74
Details of Marks Secured in (10+2) Examination -

Physics 100 54 54
Chemistry 100 63 63
Mathematics 100 33 33
Physics, Chemistry & Mathematics combined Percentage: 50
English 100 86 86
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
11/2017 Volleyball School level 1st
11/2017 Kabaddi School level 1st
How do you intend spending your time after completing class XII Final exams and before joining college ?: Work upon myself to improve my skills in different fields like sports and in academics.
Why do you wish to join TMI?: I wish to join TMI because it is the best Marine institution in India and as well as in Asia.
What are your hobbies?: Playing sports like cricket ,etc.
What are your strengths?: Self control, Honesty, Dedication.
What are your weaknesses?: Trusting someone easily.
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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