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Indian Navy Short Service Commission Application

This document contains an application format for a grant of short service commission in the Indian Navy under the University Entry Scheme for July 2011. The application requests information such as personal details, educational qualifications, branch preferences, extracurricular activities, and previous attempts at the Services Selection Board interview. The applicant and principal of the engineering college must sign declarations certifying that the information provided is accurate and that the applicant's character and suitability for the role has been verified.

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Sukrutha Cagathi
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18 views3 pages

Indian Navy Short Service Commission Application

This document contains an application format for a grant of short service commission in the Indian Navy under the University Entry Scheme for July 2011. The application requests information such as personal details, educational qualifications, branch preferences, extracurricular activities, and previous attempts at the Services Selection Board interview. The applicant and principal of the engineering college must sign declarations certifying that the information provided is accurate and that the applicant's character and suitability for the role has been verified.

Uploaded by

Sukrutha Cagathi
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

APPLICATION FORMAT FOR GRANT OF SHORT SERVICE COMMISSION IN

THE INDIAN NAVY UNDER UNIVERSITY ENTRY SCHEME – JUL 2011 COURSE

Paste your
Passport size self
Attested colour
Photograph
Regd. No. …………………………. (For Official Use only) (Do not staple)

1. Applying For Technical /Executive Branch ___________

2. Name in Block Capitals as in Matriculation Certificate :

3. Expanded full Name if abbreviated in Serial 2 above

4. Father’s Name

5. Father’s Occupation / Designation ________________________________________

6. Correspondence Address

PIN Tel No.

Mob E-mail

7. Permanent Address :
8. Nationality 9. State

10 Marital Status : Married Unmarried • 11. Gender: Male Female

12 Date of Birth (DD/MM/YY)

13. Details of (Educational Qualification) of BE/[Link]:


B.E/ Name of Name of Semester / Year wise Marks secured
[Link] College University
Institution Semester/ Maximum Marks obtained % of Marks
Year Marks
I

II

III

IV

VI

Total Marks and Overall percentage

14. If you are eligible for more than one branch/Cadre write your choice as 1sl and 2nd
choice between Technical Branch (Engg. Branch & NA Cadre) and Executive (GS-X &
Logistic Cadre) Branch:-

(a) Technical (1st) .................................. (2nd)..................................................

(b) Executive (1st) ............................... (2nd)...................................................

15. From which date have you been a student of final year of the Engineering College
……………....

16. Are you bonded to serve the Central or State Govt after passing out of Your
Engineering examination? If so give complete details showing Period of
bond......................

17. Sports, NCC, Extra Curricular Activities.......................................................................


(Give level of participation/achievement)

18. Have you attended any other SSB interview earlier for Navy/Army/Air
Force?.......................... (If yes, give details for all earlier attempts):-.............................
19. CERTIFICATE TO BE SIGNED BY THE PRINCIPAL OF ENGINEERING
COLLEGE HEAD OF THE TECHNICAL INSTITUTIONS

Certified that Shri …………………………………..is studying in this University/College


institute and that details furnished by him in Columns 1, 12,13 and 15 of the application form
have been checked with reference to relevant records and found correct.

Certified that the character so far as known to me is good. He is suitable for selection as an
officer of Indian Navy.

(Office Seal)

Place________________ Signature__________

Date ________________ Designation_________

DECLARATION

20. I, hereby, declare that I am unmarried male/female, 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.

21. 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.

22. I fully understand that in the event of any information being found false or incorrect,
action can be taken against me.

Place: .............................. Signature...............................................

Date: ............................... Name of the Applicant.

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