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


Dossier ID: LTE2178452
Applicant's Personal Information:
Full Name as on Diploma Marksheet/Pass Certificate: Shubham Shivprasad Korgaonkar
Mother's Name: Gayatri  
Marital Status (Single/Married): Single Gender (M/F): Male
Date of Birth (DD/MM/YY): 02 Jul 2001 Name as per passport:
Passport No.: Date of Expiry:
Place of Issue: Sawantawadi Nationality: Indian

((Note: If you do not have passport, you may apply for it as early as possible as passport is mandatory at the time of admission.)

Place of Birth: Bailhongal Personal Identification Mark: Two Moles on Left Hand
Blood Group: O + Address for Communication: New Khaskilwada Near Garden Teen Musi Main Road Near Municipality Shop No 6 K.B.Korgaonkar
State: Maharashtra Country: India
Pin: 416510 City/District: Sindhudurg
Mobile no: 7276315344 Telephone No. with STD code:
Aadhar Card No:855537809534 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Shivprasad Keshav Korgaonkar Relationship with candidate: Son
Parents Date of Birth: 22 Dec 1975 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: New Khaskilwada Near Garden Teen Musi Main Road Near Municipality Shop No 6 K.B.Korgaonkar
Country: India State: Maharashtra
City/District: Sawantawadi Pin: 416510
Tel: 9359561038 Mobile no.: 9423305081
Fax: Email:

Education and Academic Record :

Class X: - Diploma: - Mechanical Engineering
Year of Passing: 2017 Year of Joining: 2019
Board: Maharashtra Year of Passing: 2021
School Name: Milagros High School Board: Maharashtra
City: Sawantawadi Name of College/Institution: Shubham Shivprasad Korgaonkar
Percentage of Marks Secured: Details of Marks Secured: (in percentage)
Aggregate: 88 First year:
English: 69 Second year: 76
Address of School/College: New Khaskilwada Near Garden Teen Musi Third year: 90
Pin: 416510 Aggregate Percentage: 90
Contact Nos: 02363272149  
Why do you wish to join TMI?: TMI is the best Maritime Academy in India with the maximum training and placement. TMI has many sponsorship that we can easily get jobs.
What are your hobbies?: Collecting old rupee
What are your strengths?: I am Good in Communication
What are your weaknesses?: I work better when I am prepared
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 ________________