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: DNS2176793 Name: Sumit kumar
  Address: Near rajiv gandhi field Bikramganj
Telephone No.: Mobile no: 8709081099
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 427483378
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176793 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: DNS2176793
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Sumit kumar
Mother's Name: Sabita kumari
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 09 Oct 2003 Nationality: Indian
Place of Birth: Bihar Personal Identification Mark: Mole on forehead
Blood Group: B + Address for Communication: Near rajiv gandhi field Bikramganj
State: Bihar Country: India
Pin: 802212 City/District: Rohtas
Mobile no: 8709081099 Telephone No. with STD code:
Aadhar Card No:901491382830 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Manoj kumar Relationship with candidate: Father of candidate
Parents Date of Birth: 06 May 1974 Parent's/Guardian's Occupation/Designation: Auto driver
Office Address:
Address: Santa cruz Mumbai
Country: India State: Maharashtra
City/District: Mumbai Pin: 400047
Tel: Mobile no.: 9324207619
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Bihar
City: Bikramganj City: Bikramganj
English %: 75 Board Roll No./Seat No.: 21010472
Aggregate Percentage: 79 School/College Code: 15002
  Centre code: 15114
  Address of School/College: Bikramganj, rohtas, bihar
  Pin: 802212
  Contact Nos:
  Aggregate Percentage: 80
Details of Marks Secured in (10+2) Examination -

Physics 100 71 71
Chemistry 100 73 73
Mathematics 100 87 87
Physics, Chemistry & Mathematics combined Percentage: 77
English 100 83 83
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Studying for competitive exams
Why do you wish to join TMI?: Good campus and great placement opportunities
What are your hobbies?: Playing cricket, listening music and watching sci-fi movies
What are your strengths?: I am dedicated and having leadership qualities
What are your weaknesses?: Shyness
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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