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


  Dossier ID: DNS2178424
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Steven William Samuel
Mother's Name: Thangamani Samuel
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 07 Aug 2003 Nationality: Indian
Place of Birth: Pune Personal Identification Mark: Mole on the Left Hand
Blood Group: B + Address for Communication: B-5 Kumar Homes N.I.B.M Road Kondhwa Pune-411048 C-3 Kumar Homes N.I.B.M Road Kondhwa Pune-411048
State: Maharashtra Country: India
Pin: 411048 City/District: Pune
Mobile no: 9011698701 Telephone No. with STD code: 9011698701
Aadhar Card No:915253258053 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Thangamani Samuel Relationship with candidate: Mother
Parents Date of Birth: 16 Apr 1973 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: 5-A General Bhagat Marg Pune-411004 5-A General Bhagat Marg Pune-411004
Country: India State: Maharashtra
City/District: Pune Pin: 411048
Tel: 09011698701 Mobile no.: 9011698701
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: Maharashtra
School: The Bishops School Camp School: St Vincents Junior College
City: Pune City: Pune
English %: 80 Board Roll No./Seat No.: P010697
Aggregate Percentage: 81 School/College Code: 1115011
  Centre code: 0033
  Address of School/College: St Vincents Junior College Agarwal Colony,Camp Pune
  Pin: 411001
  Contact Nos: 02026352135
  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:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: I would try to improve myself physically,mentally and emotionally.Try to explore different things and learn about the Universe
Why do you wish to join TMI?: It is one of the best known college for Maritime studies.It is my dream to study here.
What are your hobbies?: Football,Science.Music
What are your strengths?: Leadership quality,Communication,Self Control
What are your weaknesses?: Insecure ,Sensitive
How do you intend to meet the expenses of this program?: Own Resources - My mother will be paying my fees
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.