Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science 2021)

Application Summary: Diploma in Nautical Science
Dossier ID: DNS2172111 Name: Aditya Rai
  Address: MD-1/268 LDA Colony Kanpur Road
Telephone No.: 09118730101 Mobile no: 9118730101
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 425512107
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2172111 are true and correct.
Signature of Candidate Signature of Parent/Guardian



Date ________________ Date ________________
Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail:, Web:
(New Admission Diploma in Nautical Science )


  Dossier ID: DNS2172111
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Aditya Rai
Mother's Name: Sunita Rai
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 10 Jun 2003 Nationality: Indian
Place of Birth: Lucknow Personal Identification Mark: Mole below left eye
Blood Group: B + Address for Communication: MD-1/268 LDA Colony Kanpur Road
State: Uttar Pradesh Country: India
Pin: 226012 City/District: Lucknow
Mobile no: 9118730101 Telephone No. with STD code: 09118730101
Aadhar Card No:710275839658 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Ajay Kumar Rai Relationship with candidate: Father
Parents Date of Birth: 24 Jun 1972 Parent's/Guardian's Occupation/Designation: Legal Consultant
Office Address:
Address: M/s S.S. Infrazone Pvt. Ltd., C-87, Sarojini Nagar Housing Society, Kanpur Road,
Country: India State: Uttar Pradesh
City/District: Lucknow Pin: 226008
Tel: Mobile no.: 9415276476
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: ISCE
School: City Montessori School School: City Montessori School
City: Lucknow City: Lucknow
English %: 79 Board Roll No./Seat No.:
Aggregate Percentage: 90 School/College Code:
  Centre code:
  Address of School/College: Quality Building, LDA Colony, Kanpur Road
  Pin: 226012
  Contact Nos: 9984597999
  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 ?: I consider fitness and body building both as my hobby and passion. Therefore, after 12th boards I wish to engage myself completely towards professional training, even if thats for a short duration. Moreover I look forward to participate in competitions as well.
Why do you wish to join TMI?: During my research and also while surfing through the institutes website I realized that TMI excels/leads in almost all the facilities, be it its faculty members, ex-alumnus, job placements or infrastructure. On top, degree programs at TMI have been awarded Grade A1, Outstanding, by DG Shipping. Thus, I prefer TMI over other institutes.
What are your hobbies?: Pumping Iron
What are your strengths?: Honesty, Dedication, Integrity, Flexibility, No home sickness, Physically fit
What are your weaknesses?: Public speaking, Inability to delegate
How do you intend to meet the expenses of this program?: Own Resources
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card 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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