APPLICATION FORM FOR Short Service Commission Pilot JUN 17 BATCH
(UNMARRIED CANDIDATES ONLY)
FOR INDIAN NAVY OFFICE USE ONLY
Code No:
For Office use only:
Application No:
(Affix Photograph)
VALID / INVALID
SGP1721108090
1. CHOICE OF ENTRY : [1] SSC(PILOT)
2. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:
NAME:
TANMAY
SARDANA
DATE OF BIRTH: 1995/12/14
FATHER'S NAME: GIRISH KUMAR SARDANA
FATHER'S OCCUPATION: SENIOR MANAGER INDIAN OIL CORPORATION
DOMICILE:
Delhi
[Link]:
GENDER:
INDIAN
[Link] STATUS: Unmarried
6. ADDRESS:
Male
[Link]: tanmaysardana@[Link]
PERMANENT
PRESENT
84 SWASTIK KUNJ SECTOR 13
84 SWASTIK KUNJ SECTOR 13
ROHINI
ROHINI
DISTRICT
ROHINI
ROHINI
STATE
Delhi
Delhi
PINCODE
110085
110085
TELEPHONE --NA--
011-27565419
MOBILE
9958675082
--NA--
7. EDUCATION PARTICULARS:
Qualification
Stream
Year of Passing
Percentage
[Link]
Any Discipline
2017
60.66%
Appeared With Final Year Completed/Appearing With Appearing in Final Year - Appearing
Maximum Marks
Marks Obtained
Maximum Marks
Marks Obtained
1st Semester
100
59
2nd Semester
100
62
3rd Semester
100
5th Semester
100
52
4th Semester
100
60
70.3
6th Semester
7th Semester
8th Semester
8. I HAVE NOT ATTENDED ANY SSB INTERVIEW TILL DATE
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 [Link] 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 _____________
September 20, 2016, 8:26 pm
Signature of Applicant