Ssct 45 737797mohd aslam

INDIAN ARMY DIRECTORATE GENERAL OF RECRUITING

APPLICATION FORM FOR SHORT SERVICE COMMISSION (TECHNICAL)-45 (Commencing Oct 2015) 1. Roll No. 2. Post Applied For 3. Candidate's Name 4. Father's Name 5. Mother's Name 6. Date of Birth 7. Nationality 8. Marital Status 9. Gender 10. Mobile No. 11. Email Address

737797 SSC(T)-45 MOHD ASLAM TAVARUCK HUSAIN NAZMA BEGUM 24/04/1992 INDIAN Unmarried Male 9654155737 husnaaslam786@gmail.com

12. Permanent Address

13. Correspondance Address

VII RAJAPUR HAWAI ADDA, PO PIRTHIGANJ RAILWAY STATION, PRATAPGARH, Uttar Pradesh-230304

14. SSB History: SNo.

To Be attested by Gazetted Officer

S22 SANT RAVIDAS HOSTEL GAUTAM BUDDHA UNIVERSITY, GREATER NOIDA , GAUTAM BUDDHA NAGAR, Uttar Pradesh-201310

Entry

15. Educational Details: 15(a) Type of School 15(b) Roll No of 10+2 Examination/Diploma Roll No 15(c) Education Qualification (B.E/B.Tech/B.Arch/M.Sc Comp Sc) 15(d) Whether done Diploma 15(f) Branch/Stream of Engineering in B.E/B.Tech 15(g) Stream as in Degree/Semester Marksheet 15(h) Date of Joining Engineering College 15(i) Expected Date of Completion of Degree 15(j) Name of College/Institute

Location

Others 1026077 B.Tech No Mechanical 7TH 07/07/2011 31/12/2014 GOVERNMENT INTER COLLEGE PRATAPGARH

Year/Month

15(k) Name of University 15(l) Type of University (Central University/State University/Deemed/Private) 15(m) State in which University Located 15(n) Gate Score 15(o) Valid Upto 15(p) Marks Obtained in PCM in Class XII Subject

GAUTAM BUDDHA UNIVERSITY Gr Noida State University Uttar Pradesh 0.00 -

Total Marks

Physics Chemistry Maths/Biology Cumulative Percentage

Obtained Marks

Percentage

65 51 75

65.00 51.00 75.00

100 100 100 63.67

16. Marks/Grade Obtained (whichever applicable) in Graduation Semester 1 2 3 4 5 6 7 8

CGPA

CGPA Percentage

CGPA Cumulative Percentage

5.38 5.38 5.54 6.08 5.92 7.08 8.48 8.30

5.38 5.38 5.43 5.60 5.66 5.90 6.27 6.52

10.00 10.00 10.00 10.00 10.00 10.00 10.00 10.00

Note :(a). The universities which have ‘Grade Point’ system, need to convert Grades into %age of marks scored.

Filling of cumulative %age of marks scored based on the Cumulative Grade at the end of third year/seventh semester/fourth year (as applicable) is compulsory; failing which the application will be rejected (b). For Candidates having only first year exams and not giving semester exams- Divide your first year marks in two equal halves and fill in 1st and 2nd semester. eg. 700/1000 is to be filled as 350/500 and 350/500.

17. Certificates attached with application form :(a) (b) (c) (d)

Declaration :1.

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I have read and understood the instructions and undertake to abide by them.

I hereby declare that all statements made in the application are correct and true.

I undertake not to have any objections in the event of my final selection on allotment of any Arms/Service in the interest of the organisation.

I have never been debarred from appearing in any examination or UPSC and nor have I been arrested or convicted by a criminal court or involved in any other case registered by Police.

I undertake not to make any claim or compensation if at any stage of selection, my ineligibility is detected and my candidature is cancelled as a result thereof.

This is the only application submitted for SSC(T)-45 course and any duplicate application if detected at any stage, my candidature be cancelled.

Any misinterpretation and wrong declaration/ concealment of information in the application will render my candidature to be cancelled and I may be debarred from this course.

I have never been withdrawn from NDA, IMA or OTA or any service training academy on disciplinary grounds.

8.

9. I am employed with ________________________ & I have informed my employer in writing that I am applying for commission in the Army.

10. In the eventuality of being recommended by SSB I will have no objection to be medically examined by board of Male/Female doctors, provided a lady medical officer is present (applicable only to lady cadets)

11. I undertake to be debarred & my candidature be cancelled, if at any stage of selection I indulge in any violation of local orders concerning discipline aspects

12. I undertake not to marry till I complete the full training at the training academy, in case inducted. I also understand that in case of my final selection, my appointment will be provisional subject to satisfactory police and educational verification.

13. In case of resignation from Academy, cost of training will be paid by me.

14. This application is accepted provisionally subject to meeting eligibility criteria.

Signature of the candidate Place & Date : Your Registration Date & Time:15 Jan 2015 20:55:46

Your Application Submission Date & Time:15 Jan 2015 21:14:05

Note :1.

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After applying online, candidates are requested to take a print out, paste his attested photograph in the space provided, sign it in blue ink in the space provided and carry the application without fail along with the original certificates the certificate from the college principal regarding conversion of cumulative grade into %age of marks and with a valid proof of identity to the Selection Centre when called for the interview. If candidate does not carry the above said documents to the Selection Centre for interview, his candidature will be cancelled. No need to send printout of application to Recruiting Directorate.

It may be noted that depending upon the total number of applications received by this office, Recruiting Directorate reserves the right to shortlist and to fix cut off percentage of marks for SSB interview. No representation will be entertained in this aspect.

In case the engineering stream of the candidate is not listed in the vacancies notified and candidates desire to claim equivalence, they may produce equivalence certificate of the concerned universities for the purpose and candidate will be permitted to appear interview at their own risk. Recruiting Directorate will examine the case for acceptance based on the certificate issued by the concerned university for equivalence.

Any wrong details filled in above application will lead to cancellation of the candidature and suitable action will be taken against the candidate Submission of multiple applications for SSC(T)-45 will lead to cancellation of candidature.

CERTIFICATE BY PRINCIPAL/HEAD OF THE TECHNICAL INSTITUTIONS INSTITUTIONS TO BE SUBMITTED BY FINAL YEAR/SEMESTER CANDIDATES

Certified that Shri ____________________________S/o ______________________ Date of Birth__________________ is studying in final year/final semester of B.E/B.Tech ________________ (Branch of Engineering) in this University/College/Institute and his final year/semester examinations will be over by 01 Oct 2015

Place :_______________ Date :________________

Seal

Signature_________________ Designation _________________

Note: Certificate signed by Heads of Departments will not be acceptable.