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


  Dossier ID: DNS2182413
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Roopesh kumar
Mother's Name: Kalawati Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 17 Oct 2003 Nationality: Indian
Place of Birth: Buxar Personal Identification Mark: Mark on eyebrow
Blood Group: A + Address for Communication: Mallah toli Buxar, Bihar Mallah Toli Buxar Bihar
State: Bihar Country: India
Pin: 802101 City/District: Buxar
Mobile no: 8651775002 Telephone No. with STD code:
Aadhar Card No:801995358455 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Jharkhande Prasad Relationship with candidate: Son
Parents Date of Birth: 06 Mar 1969 Parent's/Guardian's Occupation/Designation: Businessman
Office Address:
Address: Mallah toli buxar Mallah toli buxar
Country: India State: Bihar
City/District: Buxar Pin: 802101
Tel: Mobile no.: 8651775002
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Bihar
School: Saraswati vidya mandir Ahirouli buxar School: Sima kumari Uchtar high school
City: Buxar City: Buxar
English %: 58 Board Roll No./Seat No.: 21010084
Aggregate Percentage: 67 School/College Code: 14029
  Centre code: 330314
  Address of School/College: Ithari road buxar
  Pin: 802101
  Contact Nos:
  Aggregate Percentage: 73
Details of Marks Secured in (10+2) Examination -

Physics 100 79 79
Chemistry 100 55 55
Mathematics 100 75 75
Physics, Chemistry & Mathematics combined Percentage: 69.67
English 100 79 79
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: I want to spend my time for preparation for upcoming exam
Why do you wish to join TMI?: Good collage and fee is less
What are your hobbies?: Writing
What are your strengths?: I can face the critical situation
What are your weaknesses?: Over thinking
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 ________________

Last date for payment of application fees has passed. No further application fee payment will be accepted.