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: DNS2176024 Name: Jaivardhan Singh Shekhawat
  Address: Basant vIhar Sikar Rajasthan
Telephone No.: 01572270562 Mobile no: 9116444379
Application fee payment details:  
Payment Status: Offline Payment Mode: Offline
Amount: DD Number: -
Issuing Bank: - Transaction Id: -
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176024 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: DNS2176024
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Jaivardhan Singh Shekhawat
Mother's Name: Gajendra Kanwar
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 18 Oct 2000 Nationality: Indian
Place of Birth: Sikar Personal Identification Mark: Mark On right tricep side
Blood Group: B + Address for Communication: Basant vIhar Sikar Rajasthan
State: Rajasthan Country: India
Pin: 332001 City/District: Sikar
Mobile no: 9116444379 Telephone No. with STD code: 01572270562
Aadhar Card No:358638865008 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Virendra Singh Shekhawat Relationship with candidate: Father
Parents Date of Birth: 11 Apr 1996 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: Basant Vihar Sikar Rajasthan
Country: India State: Rajasthan
City/District: Sikar Pin: 332001
Tel: Mobile no.: 9116444379
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2015 Year of Passing: 2021
Board: CBSE Board: NIOS
School: Bhartiya Public School School: NIOS
City: Sikar City: Sikar
English %: 76 Board Roll No./Seat No.:
Aggregate Percentage: 76 School/College Code:
  Centre code:
  Address of School/College: Sikar
  Pin: 332001
  Contact Nos: 09116444379
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
01/2017 Cricket Tournament First
How do you intend spending your time after completing class XII Final exams and before joining college ?: Im appearing
Why do you wish to join TMI?: TMI Known by its Profession, Indian number one IMU Collge
What are your hobbies?: Playing Cricket
What are your strengths?: Work on Time
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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