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


  Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Swaraj kumar
Mother's Name: Shabnam kumari
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Jul 2004 Nationality: Indian
Place of Birth: Bhagalpur Personal Identification Mark: Cut mark on head
Blood Group: O + Address for Communication: Kanjhiya Nathnagar bhagalpur
State: Bihar Country: India
Pin: 812006 City/District: Bhagalpur
Mobile no: 9110181367 Telephone No. with STD code: 919110181367
Aadhar Card No:716339536275 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Subhash kumar Relationship with candidate: Son
Parents Date of Birth: 01 May 1977 Parent's/Guardian's Occupation/Designation: Private job
Office Address:
Address: Uco bank Brathi chouck bhagalpur
Country: India State: Bihar
City/District: Bhagalpur Pin: 812006
Tel: Mobile no.: 9110181367
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Bihar
School: Skp vidya vihar Bhagalpur School: Mlj college nathnagar
City: Bhagalpur City: Bhagalpur
English %: 71 Board Roll No./Seat No.: 21010229
Aggregate Percentage: 61 School/College Code: 71103
  Centre code: 71012
  Address of School/College: Nathnagar
  Pin: 812002
  Contact Nos:
  Aggregate Percentage: 65
Details of Marks Secured in (10+2) Examination -

Physics 100 73 73
Chemistry 100 58 58
Mathematics 100 58 58
Physics, Chemistry & Mathematics combined Percentage: 63
English 100 68 68
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Studying at home
Why do you wish to join TMI?: I want to live in the middle of ocens
What are your hobbies?: Playing games
What are your strengths?: Ability to work in team
What are your weaknesses?: Family
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 ________________

Print Summary and Application Form