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


  Dossier ID: DNS2175671
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: RA
Mother's Name: Zarin Pagarkar
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 May 2003 Nationality: Indian
Place of Birth: Ratnagiri Personal Identification Mark: Black mole beside the lips
Blood Group: AB + Address for Communication: Sagar Residency , Sector-27, Nerul-E, C-101, Plot no-98 and 99 , Navi Mumbai
State: Maharashtra Country: India
Pin: 400706 City/District: Navi Mumbai
Mobile no: 9137101561 Telephone No. with STD code:
Aadhar Card No:964152888106 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Zarin Pagarkar Relationship with candidate: Mother
Parents Date of Birth: 23 Nov 1976 Parent's/Guardian's Occupation/Designation: Housewife
Office Address:
Address: Sagar Residency , Sector-27, Nerul-E, C-101, Plot no-98 and 99 , Navi Mumbai
Country: India State: Maharashtra
City/District: Navi Mumbai Pin: 400706
Tel: Mobile no.: 9969433625
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Maharashtra
School: Tilak Public School School: St.Marys Multipurpose High School and Junior College
City: Navi Mumbai City: Navi Mumbai
English %: 91 Board Roll No./Seat No.:
Aggregate Percentage: 70 School/College Code:
  Centre code:
  Address of School/College: Vashi, Dr.Mar Theophilus Marg, Sector-10A, Navi Mumbai
  Pin: 400703
  Contact Nos: 27662725
  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 ?: After 12th exams I am planning to do short courses related to computer learning.
Why do you wish to join TMI?: I want to join TMI as it is the best institute in India or even Asia and also because I find myself a suitable candidate for this field as I am hardworking and sober and gets easily settled in any environment with positive attitude.
What are your hobbies?: Playing Badminton, Swimming,Reading Novels and Painting.
What are your strengths?: Dedication and Discipline.
What are your weaknesses?: I focus too much on details.
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.