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: Yuvraj
Mother's Name: Darshan
Gender (M/F): Female Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 12 Jan 2003 Nationality: Indian
Place of Birth: Rohtak Personal Identification Mark: Sign of cut on head
Blood Group: AB + Address for Communication: Vpo madina gindhran Vpo madina gindhran
State: Haryana Country: India
Pin: 124111 City/District: Rohtak
Mobile no: 9812767675 Telephone No. with STD code: 08708644095
Aadhar Card No:220131157778 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Ashok Relationship with candidate: Father
Parents Date of Birth: 05 Apr 1979 Parent's/Guardian's Occupation/Designation: Shopkeeper
Office Address:
Address: Vpo madina gindhran Vpo madina gindhran
Country: India State: Haryana
City/District: Rohtak Pin: 124111
Tel: Mobile no.: 8708644095
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Haryana
School: Adarsh School: Govt
City: Rohtak City: Rohtak
English %: 72 Board Roll No./Seat No.:
Aggregate Percentage: 69 School/College Code:
  Centre code:
  Address of School/College: Meham
  Pin: 124111
  Contact Nos: 08708644095
  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 ?: Watching videos of Merchant navy and preparation of imu cet
Why do you wish to join TMI?: I had listened about TMI ,when i was in 9th standard.
What are your hobbies?: Playing indoor games ,listeningusic
What are your strengths?: Honesty,Hard working
What are your weaknesses?: Taking too many risks
How do you intend to meet the expenses of this program?: Other - Relatives
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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