Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
Lateral Entry - B.Tech (Marine Engineering) 2020

Application Summary: Lateral Entry - B.Tech (Marine Engineering)
Dossier ID: LTE2065617 Name: Siddhesh Dhomse
  Address: B-304, Shivam Sankul Vijaydeep bunglow society Gaondevi road
Telephone No.: 8793615682 Mobile no: 9284341583
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 1200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 346718137
Declaration: We hereby declare that all the statements made in application form against Dossier ID LTE2065617 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 ensure that you send the following documents with your application.
  1. Write Application for Lateral Entry - Marine Engineering, Dossier ID on the envelope
  2. Printout of application form along with summary page duly filled and signed wherever indicated
  3. Three identical recent passport size photographs with name & dossier id written at the back
  4. Self – attested copies of Class X mark sheet and Pass Certificate
  5. Self – attested copies of all semester mark sheets and final mark sheet / certificate
  6. Self – attested copies of school/college leaving certificate / transfer certificate
  7. Letter from college mentioning AICTE approval number of the course and college
  8. Copy of Caste Certificate (If any)
  9. Copy of Migration Certificate
  10. Copies of sports and extra-curricular activities (Class VIII and above only)
  11. A non-refundable Demand Draft of Rs. 1200/- favouring “Tolani Maritime Institute” payable at Pune. Write your name, dossier id and contact details on the reverse of the Demand Draft (Kindly ignore if you have paid online)
  12. Please keep a copy of the form for your reference for communicating with the Institute

Send Duly filled application forms to:

Admissions Cell Lateral Entry - B.Tech (Marine Engineering)
Tolani Maritime Institute
Talegaon-Chakan road, Induri,
Talegaon, Pune, Pin- 410507

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


Dossier ID: LTE2065617
Applicant's Personal Information:
Full Name as on Diploma Marksheet/Pass Certificate: Siddhesh Dhomse
Mother's Name: Surekha  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 18 May 2001 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: Mumbai Personal Identification Mark: Small black mole on beside right eye
Blood Group: AB + Address for Communication: B-304, Shivam Sankul Vijaydeep bunglow society Gaondevi road
State: Maharashtra Country: India
Pin: 421503 City/District: Badlapur
Mobile no: 9284341583 Telephone No. with STD code: 8793615682
Aadhar Card No:576369919550 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Sayaji tukaram dhomse Relationship with candidate: Father
Parents Date of Birth: 17 May 1962 Parent's/Guardian's Occupation/Designation: Service
Office Address:
Address: Bazar gate post office Mumbai 400001
Country: India State: Maharashtra
City/District: Mumbai Pin: 400001
Tel: Mobile no.: 9029327106
Fax: Email:

Education and Academic Record :

Class X: - Diploma: - Mechanical Engineering
Year of Passing: 2017 Year of Joining: 2017
Board: Maharashtra Year of Passing: 2020
School Name: IES. katrap vidyalaya Board: Maharashtra
City: Badlapur Name of College/Institution: S. H jondhale polytechnic
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 84 First year: 61
English: 83 Second year: 66
Address of School/College: Katrap gaon Badlapur east Third year: 81
Pin: 421503 Aggregate Percentage:
Contact Nos:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
1/05/2017 military training program All india level Participation
10/09/2010 Taekwondo sports All india 2
02/2016 Drama acting Inert school higher secondary level 1st
Why do you wish to join TMI?: TMI will provide me best educational, sports and campus placement opportunities.
What are your hobbies?: Taekwondo, painting. Making DIY, playing harmonium
What are your strengths?: Anger control, pressure handling, easily mixes with people, helpful nature
What are your weaknesses?: Laziness, stubbornness, trusts people easily.
How do you intend to meet the expenses of this program?: Own Resources,Bank Loan

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

Signature of Candidate



Date ________________

Print Summary and Application Form