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.Tech. Marine Engineering
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Shubham Raj
Mother's Name: Anju Kumari
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 Jun 2004 Nationality: Indian
Place of Birth: Tarapur Personal Identification Mark: Two vaccine mark on right hand
Blood Group: O +  
Date of Birth (DD/MM/YY): 15 Jun 2004 Nationality: Indian
Gender (M/F): Male Marital Status (Single/Married): Single
Full Name (as per Passport) : Passport No.:
Date of Expiry: Place of Issue:
(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: At- Ganaili PO-Madhodih PS-Harpur Block- Tarapur dist-Munger, Bihar NA NS
State: Bihar Country: India
Pin: 813221 City/District: Munger
Mobile no: 6299585819 Telephone No. with STD code: NA
Aadhar Card No:490637187327 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Purushottam Kumar Relationship with candidate: Father
Parents Date of Birth: 15 Apr 1977 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: Na Na Na
Country: India State: Bihar
City/District: Munger Pin: 813221
Tel: Mobile no.: 8340661317
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: Paramount Academy School: Paramount Academy
City: Tarapur City: Tarapur
English %: 78 Board Roll No./Seat No.: 22635107
Aggregate Percentage: 76 School/College Code: 65445
  Address of School/College: At Tarapur PO-Tarapur PS-Tarapur dist-Munger Bihar
  Centre code: NA
  Pin: 813221
  Contact Nos: 8054546194
  Aggregate Percentage: 80
Details of Marks Secured in (10+2) Examination -

Physics 100 73 73
Chemistry 100 71 71
Mathematics 100 82 82
Physics, Chemistry & Mathematics combined Percentage: 75.33
English 100 83 83
IMU CET Application Number: CET21U1003256  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for JEE.
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Both degree are good for me but I will prefer Nautical science.
Why do you wish to join TMI?: TMI is the best and most reputed maritime institute in India and provides best career opportunities.
What are your hobbies?: Cooking and Cricket
What are your strengths?: My Family
What are your weaknesses?: Internet surfing
How do you intend to meet the expenses of this program?: Bank Loan
Review you documents:
Your passport not uploaded Class X marksheet not uploaded Leaving / Transfer Certificate / Birth 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 ________________