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: DEG21102470
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Lavish Kaushik
Mother's Name: Rupendra Kaushik
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 26 Jun 2004 Nationality: Indian
Place of Birth: Bulandshahr Personal Identification Mark: Cut of left hand
Blood Group: B +  
Date of Birth (DD/MM/YY): 26 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: Aurangabad, Rajwana RAJWANA
State: Uttar Pradesh Country: India
Pin: 245401 City/District: Bulandshahar Uttar Pradesh
Mobile no: 7055399608 Telephone No. with STD code: 07055399608
Aadhar Card No:956935363813 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Rupendra Kaushik Relationship with candidate: Father
Parents Date of Birth: 01 Jan 1996 Parent's/Guardian's Occupation/Designation: Farmer
Office Address:
Address: Aurangabad, Rajwana RAJWANA
Country: India State: Uttar Pradesh
City/District: Bulandshahar Uttar Pradesh Pin: 245401
Tel: 07055399608 Mobile no.: 7055399608
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: Uttar Pradesh Board: Uttar Pradesh
School: SD Public Inter College School: SD Public Inter College
City: Bulandshahar Uttar Pradesh City: Bulandshahar Uttar Pradesh
English %: 80 Board Roll No./Seat No.: 215321501
Aggregate Percentage: 82 School/College Code: 1294
  Address of School/College: Aurangabad, Rajwana RAJWANA
  Centre code:
  Pin: 245401
  Contact Nos: 07055399608
  Aggregate Percentage: 73
Details of Marks Secured in (10+2) Examination -

Physics 100 75 75
Chemistry 100 76 76
Mathematics 100 70 70
Physics, Chemistry & Mathematics combined Percentage: 73.67
English 100 76 76
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Approx one month
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: Because I am interested in nautical science
Why do you wish to join TMI?: I like it
What are your hobbies?: Reading story in Hindi and watch the
What are your strengths?: Many strengths
What are your weaknesses?: No weakness
How do you intend to meet the expenses of this program?: Other - Nothing
Review you documents:
Your passport not uploaded Class X marksheet Leaving / Transfer Certificate / Birth Certificate Class XII admit card not uploaded Class XII marksheet

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

Signature of Candidate



Date ________________