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: DNS2181439 Name: Amitesh Kumar Yadav
  Address: H no. 50 ,block-D Shyam Kunj,Bhondsi Gurgaon
Telephone No.: Mobile no: 7982085287
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.29 (Includes Convenience fee of ₹ 4.29 ) DD Number: -
Issuing Bank: - Transaction Id: 432368677
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2181439 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: DNS2181439
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Amitesh Kumar Yadav
Mother's Name: Sunita Yadav
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 05 Nov 2003 Nationality: Indian
Place of Birth: Gurgaon Personal Identification Mark: stitch mark on left hand
Blood Group: A + Address for Communication: H no. 50 ,block-D Shyam Kunj,Bhondsi Gurgaon
State: Haryana Country: India
Pin: 122102 City/District: Gurgaon
Mobile no: 7982085287 Telephone No. with STD code:
Aadhar Card No:486286580094 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Amarnath Yadav Relationship with candidate: Father
Parents Date of Birth: 05 Jun 1974 Parent's/Guardian's Occupation/Designation: Private sector
Office Address:
Address: VECV ,plot no.7 sector 18 Gurgaon
Country: India State: Haryana
City/District: Gurgaon Pin: 122001
Tel: Mobile no.: 9911923255
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Ryan International School Gurgaon School: Ryan International School Gurgaon
City: Gurgaon City: Gurgaon
English %: 90 Board Roll No./Seat No.:
Aggregate Percentage: 94 School/College Code:
  Centre code:
  Address of School/College: RIS, opp BSF camp ,Sohna Road ,Gurgaon
  Pin: 122102
  Contact Nos: 08045656001
  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:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
11/2016 Long Jump Inter School 2nd
10/2016 Kho Kho Inter School 1st
11/2016 Athletics Inter School 3rd
03/2018 Cricket Inter House 1st
How do you intend spending your time after completing class XII Final exams and before joining college ?: After completing my XII I will go for solo trips to exciting places in Himachal Pradesh,Uttarakhand and Rajasthan. I want to explore the world and learn new things about culture,traditions and their way of living.I will also rejoin my Cricket Academy to continue my Cricket as Cricket is something which gives me inner peace.
Why do you wish to join TMI?: Joining Merchant navy is my dream and when I began to look for good Marine Institution ,i got to know about TMI and its infrastructure and faculty. that moment I decided that I have to join this institution only.
What are your hobbies?: Playing and Watching Cricket are my prime Hobbies along with Cooking ,Dancing and Drawing.
What are your strengths?: Leadership skills, Adaptive and Social Nature , Multitasking , Self Confidence
What are your weaknesses?: Procrastination, Self doubt and Creativity
How do you intend to meet the expenses of this program?: Own Resources
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 not uploaded

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

Signature of Candidate



Date ________________

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