Application Format 126 Gdoc

APPLICATION FORM APPLICATION FOR 126 GROUND DUTY OFFICERS’ COURSE FOR MEN / 19 SHORT SERVICE COMMISSION FOR MEN / 35 SHORT SERVICE COMMISSION FOR WOMEN (*Strike out whichever is not applicable) FOR OFFICE USE ONLY (COMD HQ) CET ROLL NO

FOR AIR HQ / AFSB USE CENTRE ALLOTTED

AFSB

CODE NO

CHEST NO. (PH-I / PH-II)

1. NAME IN BLOCK CAPITALS AS IN MATRICULATION CERTIFICATE:

Affix self attested recent passport size colour photograph (DO NOT STAPLE)

2. FATHER’S NAME AS IN MATRICULATION CERTIFICATE:

3. PERMANENT ADDRESS WITH PIN CODE AND TELE NO, IF ANY:

PI N

TELE

4. PRESENT ADDRESS WITH PIN CODE AND TELE NO, IF ANY: (FOR CORRESPONDENCE)

PI N

5.

TELE E-mail address ………………………………………………………. Mobile No……………………………………...

6. CHOICE OF CET CENTRE: 1…………………………..…………. 2……………………………………………….. 7.

DATE OF BIRTH (DD/MM/YY): (As per matriculation / Equivalent Certificate) 8. MARITAL STATUS: SINGLE /MARRIED/WIDOW/DIVORCEE * 9. SEX: MALE / FEMALE * 10. Visible Identification Mark: ……………………………………………………. ………………………………………………………………………………………..

LEFT THUMB IMPRESSION FOR MEN / RIGHT THUMB IMPRESSION FOR WOMEN

11. Type of Commission: PC / SSC (M) / SSC (W) * (Men may choose both PC & SSC (M). SSC (W) for Women only) 12. Educational Qualifications:Institution & Place of Study and University

Qualification (Specify) and Medium of Instruction

13. NCC Air Wing (Senior Division) ‘C’ Certificate ………………………..

Subjects

Marks obtained in aggregate with percentage of marks & division

YES / NO

14. Appeared / Did not appear in SSB earlier for ARMY / NAVY / AIR FORCE / COAST GUARD 15. I have read the instructions carefully before sending this application. I hereby declare that all the statements made in the application are correct to the best of my knowledge and belief. I understand that any discrepancy found in the above information will lead to cancellation of my candidature / debarment. Date: ………………………….

Place: …………………………

Signature of Applicant