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Application Form For 10+2 (B Tech) Cadet Entry Jun 15 Batch

This document is an application form for a 10+2 cadet entry program with the Indian Navy. It collects personal details such as name, date of birth, address, education qualifications, and other information. The applicant, Ashok Kumar, is applying for the June 2015 batch. He is unmarried, Indian, and has a 10+2 percentage of 90%. His address and contact details are provided. His education details and marks obtained in physics, chemistry, mathematics, English at the 10+2 and 10th levels are listed. His father's occupation is also stated. He declares that all information provided is true and he has not attended any other defense selection processes before.

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31 views1 page

Application Form For 10+2 (B Tech) Cadet Entry Jun 15 Batch

This document is an application form for a 10+2 cadet entry program with the Indian Navy. It collects personal details such as name, date of birth, address, education qualifications, and other information. The applicant, Ashok Kumar, is applying for the June 2015 batch. He is unmarried, Indian, and has a 10+2 percentage of 90%. His address and contact details are provided. His education details and marks obtained in physics, chemistry, mathematics, English at the 10+2 and 10th levels are listed. His father's occupation is also stated. He declares that all information provided is true and he has not attended any other defense selection processes before.

Uploaded by

anuj
Copyright
© © All Rights Reserved
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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APPLICATION FORM FOR 10+2 (B Tech) Cadet Entry JUN 15 BATCH

(UNMARRIED MALE CANDIDATES ONLY)


FOR INDIAN NAVY OFFICE USE ONLY
Code No:

For Office use only:

Application No:

(Affix Photograph)

VALID / INVALID

PCT1537709895
1. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:
NAME:

ASHOK KUMAR

DATE OF BIRTH:

1997/07/01

FATHER'S NAME:

OM PRAKASH

PERCENTAGE (10+2):

90

2. GENDER: Male

3.NATIONALITY: INDIAN

6. ADDRESS:

4.MARITIAL STATUS: Unmarried

5.EMAIL: [email protected]

PERMANENT

PRESENT

VILL-KEDARIPUR , PO-BIRAMPUR

VILL-KEDARIPUR , PO-BIRAMPUR

DISTRICT

LAKHIMPUR KHERI

LAKHIMPUR KHERI

STATE

Uttar Pradesh

Uttar Pradesh

PINCODE

262727

262727

TELEPHONE --NA--

MOBILE

8447058065

--NA--

7. EDUCATION PARTICULARS:

7 (a) Qualification : 10+2

7 (b) PERCENTAGE :90%

Maximum Marks

Marks Obtained

MARKS IN 10+2 FOR PCM


Physics

100

92

Chemistry

100

87

Mathematics

100

91

TOTAL MARKS IN 10+2 (ALL SUBJECTS)


Total

500

454

MARKS IN ENGLISH AT 10+2 LEVEL


Total

100

96

MARKS IN ENGLISH AT 10TH/ MATRICULATION LEVEL


Total
8. Father's Occupation :

100

71

FARMER

9. I HAVE NOT ATTENDED ANY SSB TILL TO DATE WITH THE ARMY/NAVY OR THE AIR FORCE
DECLARATION
1. I hereby declare that all the statements made in the application are true to the best of my knowledge and belief and the application has been filled up by me.
2. I have never been debarred from appearing in any examination nor, have I ever been withdrawan from Defence Training Establishments on disciplinary grounds, nor have I ever been arrested, prosecuted or convicted by criminal court or
involved in any other case registered by the police. I have not submitted more than one application for this batch.
3. I undertake not to make any claim for compensation if at any stage of selection, ineligibility for my candidature is detected and my candidature is cancelled as a result thereof.
4. Any wilful misrepresentation of facts and concealment of information will result in the cancellation of the candidature and may debar me permanently or for a specific period from applying for future examinations.

Place ___________
Date _____________

Signature of Applicant

NOTE:Please forward the print out of this application duly signed to the address mentioned in the advertisement along with relevant documents by ordinary post.

December 6, 2014, 11:50 pm

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