RTG DTE 6 Additional Directorate General Of Recruiting
Roll No. 713878 INDIAN ARMY ONLINE APPLICATION FORM FOR NON UPSC ENTRIES SSC (Tech) -38 (Commencing in Apr 2012) 1.Sex Male 2.Entry
Paste passport size photo dully attested by Gazetted Officer on the application to be sent to recruiting Directorate and on the application to be carried to selection centre for interview by hand
3.Course Serial No P 1)Short Service Commission (Tech) -38 4. Candidate's Full CHOUDHARI KULDEEP PARMANAND Name 5.Nationality Indian 6.Marital Status Unmarried
7. Date of Birth 8. (a) Father's Full
02 Aug 1986 (b) Mother's PARMANAND JAGVATI Full Name [email protected] Addr: 37, Indraprasth COLOny, pipe line road, bhistbaug, savedi City :
Name 9. E-mail ID 10. Permanent
ahmednagar District : AHMEDNAGAR State : Maharashtra Pin Address 414001 Tele(Mobile) +919604430394 Current --NA-Address 11. Previous Attempt(s) at SSB : --NA-Page 1 Of 3 12. (a) Educational Qualification Engg Grad (B.E./B.Tech./M.Tech.)
(b) Branch/Stream of Engineering Electrical(Elecrical incl Electronics) (c) Date of Completion of 18 Jun 2009 degree/Completion of final exam (d) College name (e) University Name (f) State in which University Maharashtra Located 13. Marks/Grade Obtained (Whichever applicable) Semest % age of marks Cumulative %age of SGPA CGPA/DGPA(Cumu % age of er / scored marks scored (upto 2 (if lative) Marks Year (if applicable) decimals) applicab based on le) Cumulat Tota Mark %a Tota Mark Cumulat ive l s ge l s ive Grade Mar Scor Mar Scor %age /DGPA ks ed ks ed (upto 2 decimals ) 1st Semester 650.00 336.00 51.69 50.90 52.00 52.73 49.87 53.26 64.40 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 P.E.S MODERN COLLEGE OF ENGINEERING PUNE UNIVERSITY, PUNE
2nd Semester/1st 1300.00 662.00 Year 3rd Semester 750.00 390.00
4th Semester/2nd 1500.00 791.00 Year 5th Semester 750.00 374.00
6th Semester/3rd 1500.00 799.00 Year 7th Semester 750.00 483.00
8th Semester/4th 1500.00 1030.00 68.66 Year 9th Semester (Architecture Only) 0.00 0.00 0.00
0.00
0.00
0.00
0.00 0.00
0.00
10th Semester (Architecture Only)
0.00
0.00
0.00
0.00
0.00
0.00
0.00 0.00
0.00
Note :1. Filling of cumulative %age upto 2 decimal is compulsory.The Universities which have grade point system, need to convert Grades into %age of marks scored.Filling of final cumulative %age of marks scoredbased 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. 2. Candidates who have been penalised with an 'Year Back/Failed' by one or more year during degree course are ineligible to apply. 13. Certificates: (a) (b) (c)
Page 2 Of 3 Note 1. After applying online, candidates are requested to take a print out, paste his/her attested photograph in the space provided, sign it in blue ink in the space provided and send it along with attested copies of the required certificates to recruiting directorate by post. Incase of colleges having grade point system, a certificate as below signed by the college principal will be forwarded to Recruiting Directorate without fail :It is certified that Mr ------------has obtained cumulative grade 'X' which is equivalent to 'Y' % as per university/college rules. Candidates are also required to carry one more ink signed copy of the application, without fail along with the attested photograph pasted on it, all original certificates along with 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 a candidate does not send the said documents by the post to recruiting directorate and does not carry the above said documents to the selection center for the interview, his candidature will be cancelled. Applying second time on line will also lead to cancellation of candidature. 2. It may be noted that depending upon the total number of applications received by this office for TGC/SSC (T) Men course, recruitng 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. 3. Any incorrect details filled in above application will lead to cancellation of candidature and suitable action will be taken against the candidate 14. Declaration :
1. I have read and understood the instructions and undertake to abide by them. 2. I hereby declare that all statements made in the application are correct and true. 3. I undertake not to have any objections in the event of my final selection on allotment of any Arm/Service in the interest of the organistion. 4. 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. 5. 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 result thereof. 6. This is the only application submitted for this course any duplicate application if detected, my candidature be cancelled. 7. 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. 8. I have never been withdrawn from NDA, IMA or OTA or any servic training academy on displinary grounds. 9. I have obtain permission from my employer & will be release to join army if selected for 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.
Place : Signature of Date : Applicant
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