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SSC (Technical Branch)

1. This document is an application for a Short Service Commission in the Indian Navy under technical branches for the July 2011 course. 2. It requests personal details such as name, date of birth, education qualifications, correspondence and permanent addresses, nationality, state, gender, and marital status. 3. Applicants must provide details of any previous SSB interviews or service under central/state government and declare that they have never been debarred, arrested, or convicted.

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Atin Goyal
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61 views3 pages

SSC (Technical Branch)

1. This document is an application for a Short Service Commission in the Indian Navy under technical branches for the July 2011 course. 2. It requests personal details such as name, date of birth, education qualifications, correspondence and permanent addresses, nationality, state, gender, and marital status. 3. Applicants must provide details of any previous SSB interviews or service under central/state government and declare that they have never been debarred, arrested, or convicted.

Uploaded by

Atin Goyal
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 DOC, PDF, TXT or read online on Scribd
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APPLICATION FOR GRANT OF Affix your self-attested

SHORT SERVICE COMMISSION IN THE passport size recent colour


INDIAN NAVY UNDER TECHNICAL BRANCHES photograph (Don’t staple)

Regd. No……………………….. (For Official Use Only)

1. Applying for Course JUL 2011 COURSE Branch/ Cadre _________________________


2. Name in Block Capitals as in Matriculation Certificate

3. Expanded Full Name if Abbreviated in Sl 2 Above:

4. Father’s Name
5. Father’s Occupation/ Designation:
6. Date of Birth (DD/ MM/ YYYY): - -
7. Stream of BE / BTech …………………………………………………
8. Total Marks of BE/ B.Tech (Total of 1st to 8th Semester)
Marks Obtained Maximum marks Aggregate % of Marks

9. Details of (Educational Qualification) of BE/ B.Tech:


Name & Name & Semester/ Year wise Marks secured
Address Address Semester/ Maximum marks Marks Obtained % of Marks
of of Year
College/ University
Institute

II
III
IV
V
VI
VII
VIII

10. Correspondence Address:

District
PIN Mobile No Tele
Email

11. Permanent Address:

PIN
12. Nationality

13. State:

14. Marital Status: Married Unmarried

15. Gender: Male Female

16. If you are eligible for more than one branch/ Cadre write your choice [Tech (GS) Branch,
Submarine Cadre & Naval Architecture Cadre] as 1st, 2nd & 3rd Choice:
1st……………………………… 2nd…………………………… 3rd…………………………..
17. Sports, NCC, Extra Curricular Activities:…………………………………………………..
(Give level of participation/ achievement)
18. 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)
19. Have you attended any SSB interview earlier for Navy/ Army/ Air Force?………………
…… (If yes, give details of all earlier attempts)

Source of Entry Navy Army Air Force


SI
No
(a) Type of Entry
(b) Name and Station of SSB
(c) Batch No.
(d) Month and Year of Interview
(e) Whether Recommended

20. List of documents attached (as applicable):


21. (a)………………… (b)……………………(c)………………. (d)……………….. (e)
…………….

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,
action can be taken against me.

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

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