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


  Dossier ID: DNS2173830
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: Shiva raikwar
Mother's Name: Saroj devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 25 Mar 2002 Nationality: Indian
Place of Birth: Kanpur Personal Identification Mark: Spot on shoulder
Blood Group: B - Address for Communication: 1022/A Nainagarh,nagra Jhansi
State: Uttar Pradesh Country: India
Pin: 284003 City/District: Jhansi
Mobile no: 8840969208 Telephone No. with STD code: 08840969208
Aadhar Card No:959824391047 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Ravishankar raikwar Relationship with candidate: Fathwr
Parents Date of Birth: 25 Aug 1962 Parent's/Guardian's Occupation/Designation: Retired
Office Address:
Address: 1022/A Nainagarh,nagra Jhansi
Country: India State: Uttar Pradesh
City/District: Jhansi Pin: 284003
Tel: 08840969208 Mobile no.: 8840969208
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: ISCE Board: ISCE
School: Don Bosco College School: Don Bosco College
City: Jhansi City: Jhansi
English %: 63 Board Roll No./Seat No.: 60
Aggregate Percentage: 80 School/College Code: UP267
  Centre code: 2201694
  Address of School/College: Premnagar,Jhansi
  Pin: 284003
  Contact Nos: 08840969208
  Aggregate Percentage: 78
Details of Marks Secured in (10+2) Examination -

Physics 100 78 78
Chemistry 100 63 63
Mathematics 100 82 82
Physics, Chemistry & Mathematics combined Percentage: 74.33
English 100 73 73
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
04/2018 Hindi essay competition School level 3rd
04/2017 Story competition School level 2nd
05/2018 GK competition School level 2nd
04/2017 Hindi essay competition School level 2nd
How do you intend spending your time after completing class XII Final exams and before joining college ?: Ive spent all my time revising competitive exams syllabus and improving my vocabulary skills
Why do you wish to join TMI?: I have heard many good things about this college from my brothers and uncles
What are your hobbies?: I like each and every sport
What are your strengths?: I am good in studies as well as sports
What are your weaknesses?: I dont know my weaknesses
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 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 ________________

Last date for payment of application fees has passed. No further application fee payment will be accepted.