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: DNS2176469 Name: Basil lakra
  Address: Vill-khariyapara po-gumla ps-gumla Gumla
Telephone No.: Mobile no: 7070056793
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 427177822
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176469 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: DNS2176469
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Basil lakra
Mother's Name: Bimla lakra
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Dec 2002 Nationality: Indian
Place of Birth: Gumla Personal Identification Mark: Mark on neck
Blood Group: O + Address for Communication: Vill-khariyapara po-gumla ps-gumla Gumla
State: Jharkhand Country: India
Pin: 835207 City/District: Gumla
Mobile no: 7070056793 Telephone No. with STD code:
Aadhar Card No:861126121305 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Nowel lakra Relationship with candidate: Father
Parents Date of Birth: 05 Dec 1967 Parent's/Guardian's Occupation/Designation: Retired bsf army
Office Address:
Address: Vill-sarngadih ps-jari gobindpur Bhikhampur
Country: India State: Jharkhand
City/District: Gumla Pin: 835207
Tel: Mobile no.: 8340643132
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: Jharkand
School: Don Bosco School: Pampapur inter college palkot
City: Gumla City: Palkot
English %: 58 Board Roll No./Seat No.:
Aggregate Percentage: 62 School/College Code:
  Centre code:
  Address of School/College: Pampapur inter collage palkot pin-835220
  Pin: 835220
  Contact Nos:
  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
11/2016 Obstacle race School sports day 3rd
04/2021 Cricket School match 2nd
02/2021 Football School match Runner up
How do you intend spending your time after completing class XII Final exams and before joining college ?: Traveling, photography, cricket, football,geocaching
Why do you wish to join TMI?: As per I know that Tolani maritime institute is awarded the grade A1 and it is top 10 maritime institute. And I also want to take the addmission on the institute which can give me a better experience and better knowledge which I want to accuire and which I can do any more for that institute.
What are your hobbies?: Photography, geocaching
What are your strengths?: Self-control, integrity
What are your weaknesses?: Too detail oriented,creative writing
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 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 ________________

Print Summary and Application Form