Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
Marine Engineering / Nautical Science Degree Programmes
(New Admission B.Tech. Marine Engineering / B.Sc. Nautical Science )


Course: First Choice B.Sc. Nautical Science Course: Second Choice B.Sc. Nautical Science
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Yash Nigam
Mother's Name: Kiran Nigam
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 24 Jun 2001 Nationality: Indian
Place of Birth: LUCKNOW Personal Identification Mark: Small little mole in the bottom of my nose
Blood Group: A +  
Date of Birth (DD/MM/YY): 24 Jun 2001 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Yash Nigam Passport No.: V0145561
Date of Expiry: 06 Jan 2030 Place of Issue: LUCKNOW
(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.)
Address for Communication: 226,NEW ASHUTOSH NAGAR, KRISHNA NAGAR
State: Uttar Pradesh Country: India
Pin: 226023 City/District: LUCKNOW
Mobile no: 7388957687 Telephone No. with STD code:
Aadhar Card No:715857176708 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: SUSHANT NIGAM Relationship with candidate: Father
Parents Date of Birth: 02 Jan 1974 Parent's/Guardian's Occupation/Designation: Business
Office Address:
Address: Talkatora Rd, Block C, Rajajipuram
Country: India State: Uttar Pradesh
City/District: LUCKNOW Pin: 226004
Tel: Mobile no.: 7388957687
Fax: Email: YASHNIGAM24052001@GMAIL.COM

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: ISCE Board: ISCE
School: City Montessori School School: Modern Academy
English %: 64 Board Roll No./Seat No.: 6461463
Aggregate Percentage: 72 School/College Code: UP172
  Address of School/College: Near Water Tank, Viram Khand 5, Gomti Nagar, Lucknow, Uttar Pradesh
  Centre code: 2192799
  Pin: 226023
  Contact Nos: 05222726828
  Aggregate Percentage: 72
Details of Marks Secured in (10+2) Examination -

Physics 100 73 73
Chemistry 100 70 70
Mathematics 100 45 45
Physics, Chemistry & Mathematics combined Percentage: 62.67
English 100 80 80
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?:
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?:
Why do you wish to join TMI?:
What are your hobbies?:
What are your strengths?:
What are your weaknesses?:
How do you intend to meet the expenses of this program?: 
Review you documents:
Birth certificate not uploaded Class X marksheet not uploaded 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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