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


  Dossier ID:
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Rutik Jagannath Wasade
Mother's Name: Sunita
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 20 Sep 2001 Nationality: Indian
Place of Birth: YATVAMAL Personal Identification Mark: Right
Blood Group: O + Address for Communication: Nimbala Bu Post Kurai Ta Wani
State: Maharashtra Country: India
Pin: 445304 City/District: Yatvamal
Mobile no: 7666734969 Telephone No. with STD code: 07666734969
Aadhar Card No:602347568913 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Jagannath Laxman Wasade Relationship with candidate: Father
Parents Date of Birth: 10 Oct 1971 Parent's/Guardian's Occupation/Designation: Farmer
Office Address:
Address: NIMALA Post Kurai Ta Wani
Country: India State: Maharashtra
City/District: YATVAMAL Pin: 445304
Tel: 07666734969 Mobile no.: 9765247904

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2017 Year of Passing: 2019
Board: Maharashtra Board: Maharashtra
School: N V S Marathavada Highschool Parbhani School: Shivaji Science College Wangi
City: Parbhani City: Parbhani
English %: 35 Board Roll No./Seat No.: R066891
Aggregate Percentage: 100 School/College Code: 27171000168
  Centre code: 0612
  Address of School/College: Wahgi Road parbhani
  Pin: 445304
  Contact Nos: 07666734969
  Aggregate Percentage: 71
Details of Marks Secured in (10+2) Examination -

Physics 100 85 85
Chemistry 100 68 68
Mathematics 100 93 93
Physics, Chemistry & Mathematics combined Percentage: 82
English 100 38 38
IMU CET Application Number: 110373210  
How do you intend spending your time after completing class XII Final exams and before joining college ?: Yes
Why do you wish to join TMI?: Yes
What are your hobbies?: Yes
What are your strengths?: Yes
What are your weaknesses?: No
How do you intend to meet the expenses of this program?: Bank Loan - Y
Review you documents:
Birth certificate not uploaded DGS Approved Medical Fitness Certificate not uploaded Class X marksheet not uploaded School leaving 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 ________________

Print Summary and Application Form