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: DNS2176501 Name: SHARDUl THAPLIYAL
  Address: Badagaon Joshimath Chamoli uttarakhand
Telephone No.: Mobile no: 8126461616
Application fee payment details:  
Payment Status: offline payment 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 DNS2176501 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: DNS2176501
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: SHARDUl THAPLIYAL
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 28 Mar 2003 Nationality: Indian
Place of Birth: Joshimath Personal Identification Mark: White patches on left chest
Blood Group: O + Address for Communication: Badagaon Joshimath Chamoli uttarakhand
State: Uttaranchal Country: India
Pin: 246443 City/District: Joshimath chamoli
Mobile no: 8126461616 Telephone No. with STD code:
Aadhar Card No:508141433289 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Rajesh Thapliyal Relationship with candidate: Father
Parents Date of Birth: 16 Jul 1972 Parent's/Guardian's Occupation/Designation: teacher
Office Address:
Address: Salub Dungra Chamoli uttarakhand
Country: India State: Uttaranchal
City/District: Joshimath chamoli Pin: 246443
Tel: Mobile no.: 8958387171
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: CBSE
School: Jyoti vidyalaya School: Jaswant morden
City: Joshimath City: Dehradun
English %: 54 Board Roll No./Seat No.: 25609210
Aggregate Percentage: 70 School/College Code: 81030
  Centre code: 8040
  Address of School/College: Rajpur road
  Pin: 248001
  Contact Nos: 2744519
  Aggregate Percentage: 71
Details of Marks Secured in (10+2) Examination -

Physics 100 70 70
Chemistry 100 54 54
Mathematics 100 58 58
Physics, Chemistry & Mathematics combined Percentage: 60.67
English 100 82 82
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
10/2019 Basketball School level 2
How do you intend spending your time after completing class XII Final exams and before joining college ?: I have done many Trek in my locality
Why do you wish to join TMI?: My brother told me
What are your hobbies?: Playing basketball ,cricket and trekking
What are your strengths?: I am very confident and think positive
What are your weaknesses?: I literally trust every one
How do you intend to meet the expenses of this program?: Own Resources,Other - Own resources
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

I hereby declare that all the statements made above are true and correct.

Signature of Candidate



Date ________________

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