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.Tech. Marine Engineering Course: Second Choice B.Sc. Nautical Science
Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Pratyush Singh Raghuvanshi
Mother's Name: Meena Singh
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 11 Oct 2002 Nationality: Indian
Place of Birth: Nainital Personal Identification Mark: Mole on the forehead
Blood Group: A +  
Date of Birth (DD/MM/YY): 11 Oct 2002 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: C-5/3 Landmark Tower Phase 1 Chandmari Bdalalpur, Varanasi
State: Uttar Pradesh Country: India
Pin: 221002 City/District: VARANASI
Mobile no: 9336276559 Telephone No. with STD code:
Aadhar Card No:904246497872 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Manoj Kumar Singh Relationship with candidate: Father
Parents Date of Birth: 10 Oct 1970 Parent's/Guardian's Occupation/Designation: Teacher
Office Address:
Address: Chandauli Chandmari Bdalalpur, Varanasi
Country: India State: Uttar Pradesh
City/District: VARANASI Pin: 221002
Tel: Mobile no.: 7409357658
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: CBSE
School: St. Joseph Convent School School: Tomar Children School
English %: 61 Board Roll No./Seat No.: 23720172
Aggregate Percentage: 84 School/College Code: 71319
  Address of School/College: Shivpur, Varanasi
  Centre code: 7318
  Pin: 221002
  Contact Nos: 7409357658
  Aggregate Percentage: 82
Details of Marks Secured in (10+2) Examination -

Physics 100 79 79
Chemistry 100 85 85
Mathematics 100 87 87
Physics, Chemistry & Mathematics combined Percentage: 83.67
English 100 81 81
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:
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 ________________

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