Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science 2021)

Application Summary: Diploma in Nautical Science
Dossier ID: DNS2180367 Name: Deepak Kumar
  Address: At-Kalyanpur Post-Sarisabpahi Police Station-Pandaul
Telephone No.: Mobile no: 7461933761
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 431462002
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2180367 are true and correct.
Signature of Candidate Signature of Parent/Guardian



Date ________________ Date ________________
Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

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


  Dossier ID: DNS2180367
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Deepak Kumar
Mother's Name: Malti Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 05 Aug 2002 Nationality: Indian
Place of Birth: Kalyanpur Personal Identification Mark: A Cut mark on Right arm
Blood Group: B + Address for Communication: At-Kalyanpur Post-Sarisabpahi Police Station-Pandaul
State: Bihar Country: India
Pin: 847424 City/District: Madhubani
Mobile no: 7461933761 Telephone No. with STD code:
Aadhar Card No:965649891586 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Malti Devi Relationship with candidate: Mother
Parents Date of Birth: 06 Feb 1979 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: At-Baturi,Post-Andah Police Station-Pandaul
Country: India State: Bihar
City/District: Madhubani Pin: 847424
Tel: Mobile no.: 7761852175
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Bihar Board: Bihar
School: V.S.B High School Belahi School: R.K College Madhubani
City: Madhubani City: Madhubani
English %: 56 Board Roll No./Seat No.: 19010198
Aggregate Percentage: 75 School/College Code: 52001
  Centre code: 62036
  Address of School/College: Madhubani
  Pin: 847211
  Contact Nos:
  Aggregate Percentage: 74
Details of Marks Secured in (10+2) Examination -

Physics 100 61 61
Chemistry 100 77 77
Mathematics 100 81 81
Physics, Chemistry & Mathematics combined Percentage: 73
English 100 59 59
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Going on a tour and join a hobby class
Why do you wish to join TMI?: I wish to join TMI because the best Maritime academy in India with the maximum training, knowledge and placement percentage.
What are your hobbies?: Playing cricket and Watching movies
What are your strengths?: My strength are self confidence, hard work and easily mingle with others.
What are your weaknesses?: My weakness is I feel uncomfortable when i did not finish my work within a given time.
How do you intend to meet the expenses of this program?: Bank Loan
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card not uploaded Class XII marksheet

I hereby declare that all the statements made above are true and correct.

Signature of Candidate



Date ________________

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