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: Repale somnath
Mother's Name: Shakuntala
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 01 Aug 2003 Nationality: India
Place of Birth: Punewadi Personal Identification Mark: Mol on chest
Blood Group: O + Address for Communication: Kalmboli om sari ram ,sec 12 ,room no., 12 post no. 15 Kalmboli panvel raijad
State: Maharashtra Country: India
Pin: 414218 City/District: Mumbai
Mobile no: 9322619259 Telephone No. with STD code: 09322619259
Aadhar Card No:372668141858 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Sudam Relationship with candidate: Soon
Parents Date of Birth: 10 Feb 1971 Parent's/Guardian's Occupation/Designation: Private service
Office Address:
Address: Kalmboli Panvel Raijad
Country: India State: Maharashtra
City/District: Mumbai Pin: 414218
Tel: 09322619259 Mobile no.: 9322619259
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Maharashtra Board: Maharashtra
School: New English school Kalmboli School: A.D.mhatre
City: Mumbai City: Mumbai
English %: 35 Board Roll No./Seat No.:
Aggregate Percentage: 66 School/College Code:
  Centre code:
  Address of School/College: Navde
  Pin: 414218
  Contact Nos: 9322619259
  Email: somnathrepale123@gmail.comsomnathrepale
  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 ?:
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 ________________

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