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    1. The document is an application form for Short Service Commission in the Indian Navy for the June 2017 batch. It requests personal details such as name, date of birth, education qualifications, and details of previous SSB interviews attended. 2. The applicant, Abrar Khan, provides information including his name, date of birth, father's name and occupation, nationality, address, education details including completing a B.E. in Civil Engineering in 2014. 3. By filling out and signing the form, the applicant declares that he is unmarried and meets other eligibility criteria, and understands that falsified information could lead to criminal proceedings.

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    1. The document is an application form for Short Service Commission in the Indian Navy for the June 2017 batch. It requests personal details such as name, date of birth, education qualifications, and details of previous SSB interviews attended. 2. The applicant, Abrar Khan, provides information including his name, date of birth, father's name and occupation, nationality, address, education details including completing a B.E. in Civil Engineering in 2014. 3. By filling out and signing the form, the applicant declares that he is unmarried and meets other eligibility criteria, and understands that falsified information could lead to criminal proceedings.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    21 views1 page

    Applicationform PDF

    Uploaded by

    Abrar Khan
    1. The document is an application form for Short Service Commission in the Indian Navy for the June 2017 batch. It requests personal details such as name, date of birth, education qualifications, and details of previous SSB interviews attended. 2. The applicant, Abrar Khan, provides information including his name, date of birth, father's name and occupation, nationality, address, education details including completing a B.E. in Civil Engineering in 2014. 3. By filling out and signing the form, the applicant declares that he is unmarried and meets other eligibility criteria, and understands that falsified information could lead to criminal proceedings.

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    of 1

    APPLICATION FORM FOR Short Service Commission - Naval Architecture JUN 17 BATCH

    (UNMARRIED MALE/ FEMALE CANDIDATES ONLY)


    FOR INDIAN NAVY OFFICE USE ONLY

    Code No:

    For Office use only:

    Application No:
    (Affix Photograph)

    VALID / INVALID
    SEN1720700391
    1. CHOICE OF ENTRY :
    [1] SSC(NA) [3] SSC{GS(X)}

    [2] SSC{GS(Hydro)}

    2. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:

    NAME:

    ABRAR
    KHAN

    DATE OF BIRTH: 1992/08/01


    FATHER'S NAME: SALEEM KHAN
    FATHER'S OCCUPATION: FARMER
    DOMICILE:

    Madhya Pradesh

    BLOOD GROUP:
    3.NATIONALITY:

    INDIAN

    6. ADDRESS:

    GENDER:

    Male

    NCC:

    No

    4.MARITIAL STATUS: Unmarried

    5.EMAIL: abrar1892@gmail.com

    PERMANENT

    PRESENT

    JIWAJI GANJ, PRADHAN SAHAB KA BADA

    LASHKAR,GWALIOR

    JIWAJI GANJ, PRADHAN SAHAB KA BADA

    LASHKAR,GWALIOR

    DISTRICT

    GWALIOR

    GWALIOR

    STATE

    Madhya Pradesh

    Madhya Pradesh

    PINCODE

    474001

    474001

    TELEPHONE --NA--

    MOBILE

    8871929474

    --NA--

    7. EDUCATION PARTICULARS:
    Qualification

    Stream

    Year of Passing

    Percentage

    B.E

    Civil Engineering

    2014

    67%

    Maximum Marks

    Marks Obtained

    Maximum Marks

    Marks Obtained

    1st Semester

    10

    6.13

    2nd Semester

    10

    5.87

    3rd Semester

    10

    5th Semester

    10

    7.31

    4th Semester

    10

    6.94

    7.25

    6th Semester

    10

    7.56

    7th Semester

    10

    7.75

    8th Semester

    10

    8.63

    8. DETAILS OF SSB INTERVIEW(S) ATTENDED:


    Service

    Type of Entry

    Name of SSB

    Month and Year

    Batch No

    Rec/ Not Rec

    Army

    TGC 123

    20 SSB Bhopal

    march 2016

    Not Rec

    Army

    ssc tech 47

    21 SSB Bhopal

    may 2016

    Not Rec

    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 _____________

    August 24, 2016, 10:34 am


    Signature of Applicant

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