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: Hemant Sehgal
Mother's Name: Seema Sehgal
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 02 Oct 2002 Nationality: Indian
Place of Birth: Delhi Personal Identification Mark: Mole on chin
Blood Group: B + Address for Communication: D-729 , Ganesh nagar-2 Shakarpur , Delhi-92
State: Delhi Country: India
Pin: 11092 City/District: New Delhi
Mobile no: 8130392035 Telephone No. with STD code:
Aadhar Card No:389786701879 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Harish Kumar Sehgal Relationship with candidate: Father
Parents Date of Birth: 13 Aug 1974 Parent's/Guardian's Occupation/Designation: Service
Office Address:
Address: Preet vihar Delhi-92
Country: India State: Delhi
City/District: New Delhi Pin: 110092
Tel: Mobile no.: 9999663920
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Bal Mandir sr. sec. School School: Bal Mandir Sr. Sec. School
City: Delhi City: Delhi
English %: 95 Board Roll No./Seat No.: 14608543
Aggregate Percentage: 85 School/College Code: 25043
  Centre code: 2520
  Address of School/College: Defence enclave , Vikas Marg ,Delhi
  Pin: 110092
  Contact Nos:
  Aggregate Percentage: 79
Details of Marks Secured in (10+2) Examination -

Physics 100 73 73
Chemistry 100 77 77
Mathematics 100 79 79
Physics, Chemistry & Mathematics combined Percentage: 76.33
English 100 87 87
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
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