Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
Lateral Entry - B.Tech (Marine Engineering)


Dossier ID: LTE2054940
Applicant's Personal Information:
Full Name as on Diploma Marksheet/Pass Certificate: Roshan Tiwari
Mother's Name: Sunita tiwari  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 22 Dec 1997 Name as per passport:
Passport No.: Date of Expiry:
Place of Issue: Nationality:

(Note: If you do not have passport, you may apply for it as early as possible as passport is required for obtaining Seaman’s Discharge Certificate, mandatory for boarding a ship.)

Place of Birth: Ballia Personal Identification Mark: Mole on right hand between thumb and index finger
Blood Group: B + Address for Communication: Zirabasti Zirabasti Zirabasti
State: Uttar Pradesh Country: India
Pin: 277001 City/District: Ballia
Mobile no: 7844934964 Telephone No. with STD code:
Aadhar Card No: E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Om Prakash Tiwari Relationship with candidate: Father
Parents Date of Birth: 19 Oct 1973 Parent's/Guardian's Occupation/Designation: Defence
Office Address:
Address: Aizwal Aizawl crpf
Country: India State: Mizoram
City/District: Aizwal Pin: 277001
Tel: Mobile no.: 9621143945
Fax: Email:

Education and Academic Record :

Class X: - Diploma: - Mechanical Engineering
Year of Passing: 2012 Year of Joining: 2015
Board: CBSE Year of Passing: 2018
School Name: St Xavier school Board: Uttar Pradesh
City: Ballia Name of College/Institution: Town polytechnic Ballia
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 81 First year: 69
English: 85 Second year: 67
Address of School/College: Dharahara Ballia Uttar Pradesh Third year: 79
Pin: 277001 Aggregate Percentage: 79
Contact Nos:  
Why do you wish to join TMI?: I have seen review of different people who passed out from tmi. So i think tmi gives me a platform to skill out my potential .
What are your hobbies?: Debate on particular topics.
What are your strengths?: I have patience.
What are your weaknesses?: Expectations.
How do you intend to meet the expenses of this program?: Bank Loan

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

Signature of Candidate



Date ________________