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: DEG2170286
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Rahul Kumar
Mother's Name: Poonam Devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 21 Apr 2004 Nationality: Indian
Place of Birth: Bariya tola Personal Identification Mark: I have cut in right eyebrow
Blood Group: A +  
Date of Birth (DD/MM/YY): 21 Apr 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: Latiyahi ,Bariya tola Post andhara, Anchal Adapur
State: Bihar Country: India
Pin: 845433 City/District: East Champaran
Mobile no: 6200891829 Telephone No. with STD code:
Aadhar Card No:448033418736 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Brijkishor prasad Chaurasiya Relationship with candidate: Father
Parents Date of Birth: 01 Jan 1974 Parent's/Guardian's Occupation/Designation: Farmer
Office Address:
Address: Latiyahi ,Bariya tola Post andhara, Anchal Adapur
Country: India State: Bihar
City/District: East Champaran Pin: 845433
Tel: Mobile no.: 9801193130
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: Bihar
School: Cambridge public school School: R.R.SAH COLLEGE
City: Raxaul City: Raxaul
English %: 76 Board Roll No./Seat No.:
Aggregate Percentage: 81 School/College Code:
  Address of School/College: Raxaul, East Champaran
  Centre code:
  Pin: 845305
  Contact Nos:
  Aggregate Percentage:
Details of Marks Secured in (10+2) Examination -

Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
IMU CET Application Number:  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Preparing for college exam
Why do you think your degree in Marine Engeneering/Nautical Science is good option for you?: After degree getting better job, good Placement
Why do you wish to join TMI?: It provides 100percent placement and high ranking
What are your hobbies?: Watching and playing cricket
What are your strengths?: Thinking is high
What are your weaknesses?: In some games
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 ________________