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    To, President Central Airmen Selection Board PO Box: 11807 New Delhi-110010 83

    Uploaded by

    Gaurav Kumar
    This document contains a registration form for Ashish Dixit, an Indian citizen born on November 13, 1998 who is applying unmarried with an Intermediate qualification from the UP Board of Higher Secondary Education with 83% in English. He is providing contact information, personal details like height, identification marks and exam center preferences. He is declaring that all information provided is correct and undertaking to submit original documents and undergo physical tests if selected.

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    To, President Central Airmen Selection Board PO Box: 11807 New Delhi-110010 83

    Uploaded by

    Gaurav Kumar
    29 views1 page
    This document contains a registration form for Ashish Dixit, an Indian citizen born on November 13, 1998 who is applying unmarried with an Intermediate qualification from the UP Board of Higher Secondary Education with 83% in English. He is providing contact information, personal details like height, identification marks and exam center preferences. He is declaring that all information provided is correct and undertaking to submit original documents and undergo physical tests if selected.

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    16033479638.pdf

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    This document contains a registration form for Ashish Dixit, an Indian citizen born on November 13, 1998 who is applying unmarried with an Intermediate qualification from the UP Board of Higher Secondary Education with 83% in English. He is providing contact information, personal details like height, identification marks and exam center preferences. He is declaring that all information provided is correct and undertaking to submit original documents and undergo physical tests if selected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    29 views1 page

    To, President Central Airmen Selection Board PO Box: 11807 New Delhi-110010 83

    Uploaded by

    Gaurav Kumar
    This document contains a registration form for Ashish Dixit, an Indian citizen born on November 13, 1998 who is applying unmarried with an Intermediate qualification from the UP Board of Higher Secondary Education with 83% in English. He is providing contact information, personal details like height, identification marks and exam center preferences. He is declaring that all information provided is correct and undertaking to submit original documents and undergo physical tests if selected.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Office Use Office Use Office Use Registration No

    16033479638

    1.Candidate Name ASHISH DIXIT 2.Parent Name CHANDRA 3.Nationality Indian


    SHEKHAR
    SHARMA

    4.Date Of Birth 13-11-1998 5.Marital Status Un Married 6.Qualification Intermediate EPM

    7.Intermediate/Voca 83 8.Name of UP Board of 9.Matric Board Central Board of


    tional/Diploma Intermediate/vocatio Higher School & Secondary
    English % nal/Diploma Intermediate Education
    Education

    10.Matric Roll No 5102657 11.Aggregate 83 12.Mobile No 9927460792

    13.EMail Id anilarela@gmail.co 14.SOAFP No 15.Discharged from No


    m Forces

    16.Stream Applied Group-XY 17.Identification A MOLE ON 18.Candidate Height 166.0cm


    mark HEAD

    19.Exam Center ASC-2 New Delhi 20.Exam Center ASC-3 Kanpur 21.Exam Center ASC-15 Bhopal
    Choice 1 Choice 2 Choice 3

    22.Permanent 1734,BAROLI 23.Communication 1734,BAROLI 24.Preference for 1st preference: X


    Address AHIR,BAROLI Address AHIR,BAROLI group XY candidate 2nd preference: Y
    AHIR,Agra,Uttar AHIR,Agra,Uttar only
    Pradesh,282001, Pradesh,282001,

    25.Chest Size 34 Inch 26.Waist Size 32 Inch 27.Shoe Size 7 No.(Bata)


    DECLARATION BY THE CANDIDATE
    I hereby declare that all statements made in this application are correct.I understand that I am
    liable to be disqualified at any stage, if the information given is found to be
    incorrect/incomplete/false. I undertake to produce all original certificates and statement of marks
    and three photocopies of each, duly attested by a Gazetted Officer, at the time of appearing in the
    Paste your
    Selection test. I am willing to undergo physical and medical test, at my own risk and will not be
    entitled for compensation for injuries if any, sustained during such test. I am aware that the photograph
    decision by President, CASB will be final and binding on me.

    Signature of the candidate

    Left Hand Thumb


    Signature of parent/guardian impression
    (If candiddate below 18 yrs on the day of filling application)
    -------------------------
    1 60334 79638 0
    Name(Gaurdian if applicable ) :
    Place:

    Date:

    -----------------------Tear off and Paste on Envelope------------------- -----------------------Tear off and Paste on Envelope-------------------

    To, 16033479638
    President Group-XY
    Central Airmen Selection Board
    PO Box: 11807
    New Delhi-110010 1 60334 79638 0 83

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