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: Suryansh sungh
Mother's Name: Nutan singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 25 May 2004 Nationality: Indian
Place of Birth: Varanasi Personal Identification Mark: Mole on neck
Blood Group: B + Address for Communication: Thane bhiwandi Purna deepraj residency
State: Maharashtra Country: India
Pin: 421302 City/District: Bhiwandi
Mobile no: 9527791092 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Nutan singh Relationship with candidate: Mom
Parents Date of Birth: 01 Jan 1970 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: Thane bhiwandi Purna deepraj residency
Country: India State: Maharashtra
City/District: Bhiwandi Pin: 421302
Tel: Mobile no.: 9527791092
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Maharashtra
School: MJF public school School: SHVOV jr college
City: Varanasi City: Bhiwandi
English %: 73 Board Roll No./Seat No.:
Aggregate Percentage: 54 School/College Code:
  Centre code:
  Address of School/College: Bhiwandi Anjur phata
  Pin: 421302
  Contact Nos: 9527791092
  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 ?: By Preparing for my sponsorship exams
Why do you wish to join TMI?: Its one of the best college for DNS. So I prefer it for sponsorship
What are your hobbies?: Football , swimming
What are your strengths?: Punctuality. Hardwotking
What are your weaknesses?: I feel very low when am not able to do work in given time
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 ________________

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