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Paste Your Recent Self Attested Passport Size Colour Photograph (Don, T Staple Self Attested

This document contains an application format for an unmarried man or woman applying for a Short Service Commission as an Air Traffic Controller in the Indian Navy. The application requests basic personal details such as name, father's name, date of birth, gender, contact information, educational qualifications and marks obtained, details of any previous SSB interviews, and a declaration that the applicant has never been arrested or convicted of a crime. It instructs applicants to attach a recent passport photo and provides spaces to fill in qualifications, percentages obtained, and other relevant details.

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102 views3 pages

Paste Your Recent Self Attested Passport Size Colour Photograph (Don, T Staple Self Attested

This document contains an application format for an unmarried man or woman applying for a Short Service Commission as an Air Traffic Controller in the Indian Navy. The application requests basic personal details such as name, father's name, date of birth, gender, contact information, educational qualifications and marks obtained, details of any previous SSB interviews, and a declaration that the applicant has never been arrested or convicted of a crime. It instructs applicants to attach a recent passport photo and provides spaces to fill in qualifications, percentages obtained, and other relevant details.

Uploaded by

gaffar87mca
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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APPLICATION FORMAT

APPLICATION FOR GRANT OF SHORT SERVICE COMMISSION


AIR TRAFFIC CONTROLLER IN THE INDIAN NAVY FOR UNMARRIED MEN
AND WOMEN
Paste your
recent self
Regd. No……… (For office use only) attested
Regd. No………………………. Passport size
Colour
1. Applying for course Photograph
2. Name in BLOCK capitals as in Matriculation Certificate (Don,t staple
self attested

3. Expanded Name if abbreviated in SI .2 above (abbreviated part only)

4. Fathers Name

5. Father’s Occupation/ Designation………………………………..


6. Permanent Address:

District
State PIN Mobile

7. Correspondence Address

District
State Mobile
Email Pin

8 Nationality

9
Domicile
10 Date of Birth
(DD/MM/YYYY)

11 Marital Status (Married/Unmarried)… 12 Gender : Male Female

13. Details of Marks Secured in Graduation (in Physics Mathematics or Electronics


and above

Exam Passed Semester/ Year wise marks secured


Semester/ Marks Maximum % of marks
Year Obtained Marks
Graduation I
II
III
IV
V
VI

Total Marks & overall


percentage
Post 1st Year
Graduation 2nd Year
Total Marks & Overall
Percentage

14 Name of college where studied and address


15 Name of University to which college affiliated and Address
16 Have you attended any other SSB interview earlier If yes, give details for all earlier
Attempts

Service Type of Name of Month & Batch No. Rec/Not Rec


Entry SSB Year of SSB
Navy
Army
Air
Force

17 Details of service under Central/ State Govt. if


any…………………………………
(Candidates already in service should apply through proper channel and obtain
NOC from the present employer)
DECLARATION
8. I hereby declare that I am unmarried male/female, governed by nationality
conditions as laid down by the Govt. of India, and have never been debarred from
appearing at any examination nor have I never been arrested/ prosecuted and
convicted by a criminal court or involved in any other case registered by the Police.
9. 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.
10. I fully understand that in the event of any information being found false or
incorrect, appropriate action can be taken against me.

Place:……………………………. Signature…………………………..
Date:……………………………... Name of the Applicant……………..

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