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


  Dossier ID: DNS2177331
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Nishant Singh
Mother's Name: Sandhya Singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 22 Dec 2003 Nationality: Indian
Place of Birth: Gorakhpur Personal Identification Mark: A mole on right thumb
Blood Group: A + Address for Communication: 1695, Pushpendra Nagar, Near Vivekanand Mahila Maha Vidalaya Saheed Path, Lucknow
State: Uttar Pradesh Country: India
Pin: 226025 City/District: Lucknow
Mobile no: 8005194429 Telephone No. with STD code:
Aadhar Card No:765610132667 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Raj Kumar Singh Relationship with candidate: Father
Parents Date of Birth: 18 Nov 1978 Parent's/Guardian's Occupation/Designation: Income Tax Department
Office Address:
Address: Aaykar Bhawan Ashok Marg-5 Hazratganj, Lucknow
Country: India State: Uttar Pradesh
City/District: Lucknow Pin: 226001
Tel: Mobile no.: 6386163501
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Army Public School LBS Marg School: Army Public School LBS Marg
City: Lucknow City: Lucknow
English %: 96 Board Roll No./Seat No.:
Aggregate Percentage: 97 School/College Code:
  Centre code:
  Address of School/College: Army Public School LBS Marg, Cantonment, Lucknow
  Pin: 226002
  Contact Nos: 05222296931
  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
05/2021 Badminton Intra Cluster HQ Central Command Runner up
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparation for JEE
Why do you wish to join TMI?: I am interested in Merchant Navy and to explore world
What are your hobbies?: Computer Games and listening music
What are your strengths?: I am always ready to give my best in all aspects
What are your weaknesses?: As per my view nothing is my weakness
How do you intend to meet the expenses of this program?: Bank Loan
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 ________________

Last date for payment of application fees has passed. No further application fee payment will be accepted.