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Indian Navy

The document is an application form for admission to the 10+2 cadet entry program for the December 2012 batch of the Indian Navy. It contains personal details of the applicant such as name, father's name, date of birth, gender, nationality, address, education qualifications including marks obtained at 10th and 12th standards. The applicant declares that he is unmarried and has never attended Services Selection Board tests with the Army/Navy or Air Force in the past. He also solemnly declares that all information provided in the application is true to the best of his knowledge.

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Shiva Srt
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143 views1 page

Indian Navy

The document is an application form for admission to the 10+2 cadet entry program for the December 2012 batch of the Indian Navy. It contains personal details of the applicant such as name, father's name, date of birth, gender, nationality, address, education qualifications including marks obtained at 10th and 12th standards. The applicant declares that he is unmarried and has never attended Services Selection Board tests with the Army/Navy or Air Force in the past. He also solemnly declares that all information provided in the application is true to the best of his knowledge.

Uploaded by

Shiva Srt
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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APPLICATIO N FO RM FO R 10+2 (B Te ch) Cade t Entry De c 12 BATCH (UNMARRIED MALE CANDIDATES O NLY) FO R INDIAN NAVY O FFICE USE O NLY

CO DE NO . VALIDITY STATUS APPLICATIO N NO -PCT1237711612

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1. T YPE OF ENT RY-10+2 (B T ech) Cadet Entry 2. PERSONAL PART ICULARS AS IN MAT RICULAT ION CERT IFICAT E:NAME FAT HER'S NAME DAT E OF BIRT H GENDER PRASANTH SRIVATSAV Ramthilak R 1994-09-13 Male

3.FAT HER'S OCCUPAT ION/DESIGNAT ION: Chie f Manage r 4.NAT IONALIT Y: INDIAN 7. ADDRESS: . ADDRESS DIST RICT ST AT E PINCODE T ELEPHONE MOBILE EMAIL CORRESPONDENCE ADDRESS Plot No 62 Ne w no 5 Lakshmi nagar East main road Nangnalur Che nnai Tamilnadu 600061 044 - 22243843 8015818153 [email protected] PERMANENT ADDRESS Plot No 62 Ne w no 5 Lakshmi nagar East main road Nangnalur Che nnai Tamilnadu 600061 044 - 22243843 --NA---NA-5.DOMICILE: Tamilnadu 6.MARIT IAL ST AT US:Unmarrie d

8.EDUCAT ION PART ICULARS: 8(a).QUALIFICAT ION: Inte rme diate Scie nce (PCM) 8(c).YEAR OF EXAM PASSED: 2012 TO TAL MARKS IN 10+2 Maximum Marks T otal 10+2 Marks DETAIL MARKS IN 10+2 FO R PCM Physics Chemistry Maths TO TAL MARKS IN ENGLISH AT 10+2 LEVEL English (10+2) English (10th) 100 100 100 100 100 500

8(d).PERCENT AGE(PCM): 94% Marks Obtained 465 95 91 96 84 86

TO TAL MARKS IN ENGLISH AT 10TH/ MATRICULATIO N LEVEL 11. I HAVE NOT AT T ENDED ANY SSB T ILL T O DAT E WIT H T HE ARMY/NAVY OR T HE AIR FORCE.
DECLARATION 1.I, hereby declare that I am unmarried male/female, governed by nationality condition as laid down by the Government of India and have never been debarred from appearing at any examination. I have never been arrested/prosecuted and convicted by a criminal court or involved in any other case registered by the Police. 2. I, hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my knowledge and belief. 3. I, fully understand that in the event of any information being found false or incorrect, appropriate action can be taken against me. Note:Please forward printout of this application duly signed along with relevant documents to Post Box.4,Nirman Bhawan, New Delhi 110 021.

Place : .............................. Date : ...............................

Signature: .............................................. Name of Applicant: ..............................

June 6, 2012, 11:43 am

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