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: DNS2175650 Name: Ishita Singh
  Address: A/17proffesorcolony Aghoriya bazar
Telephone No.: Mobile no: 7091062588
E-mail: ISHI7046@GMAIL.COM  
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 427358812
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2175650 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: DNS2175650
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Ishita Singh
Mother's Name: Pratima Singh
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 16 Feb 2003 Nationality: Indian
Place of Birth: Muzaffarpur Personal Identification Mark: Mole on right thumb
Blood Group: A + Address for Communication: A/17proffesorcolony Aghoriya bazar
State: Bihar Country: India
Pin: 842002 City/District: Muzaffarpur
Mobile no: 7091062588 Telephone No. with STD code:
Aadhar Card No:537494715044 E-mail: ISHI7046@GMAIL.COM
Guardian's Particulars:
Name of Parent/Guardian: Prabhat Kumar Relationship with candidate: Father
Parents Date of Birth: 11 Sep 1968 Parent's/Guardian's Occupation/Designation: Service
Office Address:
Address: A/14proffesorcolony Aghoriya bazar
Country: India State: Bihar
City/District: Muzaffarpur Pin: 842002
Tel: 09835492588 Mobile no.: 9835492588
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Prabhat Tara School School: Holy cross public school
City: Muzaffarpur City: Muzaffarpur
English %: 89 Board Roll No./Seat No.:
Aggregate Percentage: 83 School/College Code:
  Centre code:
  Address of School/College: Manika Bishanpur chand,
  Pin: 843119
  Contact Nos: 7091062588
  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 ?: I want to learn new things.
Why do you wish to join TMI?: I wish to join TMI because of the job opportunity of this collage and also the reputation.
What are your hobbies?: Playing guitar
What are your strengths?: My confidence
What are your weaknesses?: Nothing
How do you intend to meet the expenses of this program?: Bank Loan
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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