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APPLICATION FORM FOR Short Service Commission Executive (GS (X) ) JUN 16 BATCH

Rajeev Singh has applied for the position of Short Service Commission Executive(GS(X)) in the Indian Navy for the June 2016 batch. He is currently unmarried and holds an Indian nationality. Rajeev has completed his B.E. in Electronics and Communication in 2013 from Jharkhand and is currently residing in Bangalore. He maintains a 69.61% aggregate in his B.E. and has not attended any SSB interviews to date. Rajeev declares that he meets all eligibility criteria and conditions for the role and that all information provided in the application is true.

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Ankur Sharma
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46 views1 page

APPLICATION FORM FOR Short Service Commission Executive (GS (X) ) JUN 16 BATCH

Rajeev Singh has applied for the position of Short Service Commission Executive(GS(X)) in the Indian Navy for the June 2016 batch. He is currently unmarried and holds an Indian nationality. Rajeev has completed his B.E. in Electronics and Communication in 2013 from Jharkhand and is currently residing in Bangalore. He maintains a 69.61% aggregate in his B.E. and has not attended any SSB interviews to date. Rajeev declares that he meets all eligibility criteria and conditions for the role and that all information provided in the application is true.

Uploaded by

Ankur Sharma
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 Short Service Commission Executive{GS(X)} JUN 16 BATCH

(UNMARRIED MALE/ FEMALE CANDIDATES ONLY)


FOR INDIAN NAVY OFFICE USE ONLY

Code No:

For Office use only:

Application No:
(Affix Photograph)

VALID / INVALID
SGX1630802440
1. CHOICE OF ENTRY : [1] SSC{GS(X)}
2. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:

NAME:

RAJEEV SINGH

DATE OF BIRTH:

1992/04/01

FATHER'S NAME:

RADHE SHYAM SINGH

FATHER'S OCCUPATION:

ADVOCATE

DOMICILE:

Bihar

GENDER:

Male

NCC:

No

BLOOD GROUP:
3.NATIONALITY:

INDIAN

6. ADDRESS:

4.MARITIAL STATUS: Unmarried

5.EMAIL: [email protected]

PERMANENT

PRESENT

SECTOR-12EQR NO.-1088BOKAROJHARKHAND

BTM 1ST STAGE AKBAR BUILDING CLASSIC PGGURAPANPALLYA

DISTRICT

BOKARO

BANGALORE

STATE

Jharkhand

Karnataka

PINCODE

827012

560029

TELEPHONE --NA--

065422-57558

MOBILE

7812923145

--NA--

7. EDUCATION PARTICULARS:
Qualification

Stream

Year of Passing

Percentage

B.E

Electronics and Communication

2013

69.61%

Maximum Marks

Marks Obtained

Maximum Marks

Marks Obtained

1st Semester

700

481

2nd Semester

700

544

3rd Semester

750

465

4th Semester

750

488

5th Semester

750

477

6th Semester

750

532

7th Semester

750

542

8th Semester

750

578

8. I HAVE NOT ATTENDED ANY SSB INTERVIEW TILL DATE

DECLARATION
1.I, hereby declare that I am unmarried, 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.
4. Eligibility criteria will be verified on reporting at the selection centres. If found ineligible, I understand that criminal proceedings can be initiated against me for fraudulent entry and falsification of GOI
documents. I also accept that no TA/DA will be admissible to me in such cases.
5. I have completed my B.E as on date.

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
ONLY. You will be intimated via Email or SMS regarding your SSB Call-up, if shortlisted. Kindly check your Email inbox regularly.
Place ______________

Date _____________

September 11, 2015, 2:38 pm


Signature of Applicant

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