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
  Address: 1B-322avas vikas colony Shikohabad , Firozabad
Telephone No.: Mobile no: 8791784354
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 204.83 (Includes Convenience fee of ₹ 4.83 ) DD Number: -
Issuing Bank: - Transaction Id: 429179388
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2178097 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: DNS2178097
Applicant's Personal Information:
Full Name as on Class XII Marksheet/Pass Certificate: RAGHVENDRA SINGH YADAV
Mother's Name: Meera devi
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 15 May 2003 Nationality: Indian
Place of Birth: Uttar parde Personal Identification Mark: Black dot on left wrist
Blood Group: A + Address for Communication: 1B-322avas vikas colony Shikohabad , Firozabad
State: Uttar Pradesh Country: India
Pin: 283135 City/District: Firozabad
Mobile no: 8791784354 Telephone No. with STD code:
Aadhar Card No:275919677709 E-mail:
Guardian's Particulars:
Name of Parent/Guardian: Omsaran yadav Relationship with candidate: Father
Parents Date of Birth: 06 Apr 1969 Parent's/Guardian's Occupation/Designation: Army
Office Address:
Address: 1B-322avas vikas colony , Shikohabad Firozabad
Country: India State: Uttar Pradesh
City/District: Firozabad Pin: 283135
Tel: Mobile no.: 8791784354
Fax: Email:

Education and Academic Record :

Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: CBSE Board: CBSE
School: Gyan deep Sr. Sec. School School: Gyandeep sr. Sec school
City: Shikohabad City: Shikohabad
English %: 81 Board Roll No./Seat No.: 21637194
Aggregate Percentage: 84 School/College Code: 08859
  Centre code: 60070
  Address of School/College: Shanti nagar, shikohabad
  Pin: 283135
  Contact Nos: 9458451343
  Aggregate Percentage: 81
Details of Marks Secured in (10+2) Examination -

Physics 100 68 68
Chemistry 100 58 58
Mathematics 100 62 62
Physics, Chemistry & Mathematics combined Percentage: 62.67
English 100 93 93
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
09/2016 Football Interschool 2nd
08/2017 National student science Congress District level 5th
09/2021 National student science Congress State level 4th
12/2020 Drama Interhouse 1st
How do you intend spending your time after completing class XII Final exams and before joining college ?: Spending time with friends and family , and asking elder cousin for future carrier, doing gym For healthy lifestyle . And start preparing for competative exam
Why do you wish to join TMI?: My elder brother recommended me and also my cousin is passout student of tmi now he is a 3 rd officer in wsm. Placement record is impressive
What are your hobbies?: Writting poem and shyari football , listening song and travelling
What are your strengths?: Self control , postive mind , creativity , dedication
What are your weaknesses?: Speaking fluent English , lazy , swimming
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 ________________

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