APPLICATION FORM OF CANDIDATES FOR SELECTION IN INDIAN AIR FORCE AS AGNIVEERVAYU Both Science and other than

Science Subjects: INTAKE 01/2026

Payment Status: Online Payment Success Registration No.: 25010178610

Candidate's Full Name Kota Venkatesh Father's Name Kota Yarranna

Mother's Name Kota Geetha Nationality Indian

Date of Birth (dd-mm-yyyy) 02-02-2006 Marital Status Unmarried

Mobile No. +918688466130 Email Id venkateshkota517@[Link]

Gender Male Aadhaar Card No. 566990676391

Qualification 12th Is Qualification with Physics/Math Yes

Board of Intermediate Education,

Name of Education Board
Andhra Pradesh 12th Stream Science

Aggregate % 86 English % 71

Physics % 93 Mathematics % 89

Additional Marksheet No

Computer Knowledge Yes Computer Knowledge Type Basic

Higher Education Qualification

Pursuing
Status

Engineering / Non-Engineering Non-Engineering Non-Engineering Stream Science

Grading system as per mark sheet Percentage

[Link]. Subject Obtained Marks Total Marks

1 English 143 200

Subject wise Marks
2 Maths 269 300

3 Physics 140 150

COAFP No Serving IAF NC(E) No

NCC Certificate Holder Yes

NCC Certificate Type A NCC Certificate No. AP18JDN276293

Driving Known No

Knowledge in Any Trade (Welding ,

Soldering , Lathe work or any related No
work)

Qualification in Catering No

Any Other Skills / Qualification /

Information Technology Known No No
Achievements / Work Experiences

Accounting Known No

Any Representation / Achievement

No
in any Sports event or discipline
Languages known, other than
Yes Languages known TELUGU
English / Hindi

Candidate Medical History (To

include Major illness/ Major I Have No Medical History in my body
Surgery/ Allergy if any)

Family Medical History (Parents/

Siblings only) (To include Major
my family hve no medical history
illness/ Major Surgery/ Allergy if
any)

Discharged from Forces/Govt.

No
Organization

Both Science and other than

Category Applied Identification Mark A MOLE ON THE RIGHT ARM
Science Subjects

Candidate Height 170.0

Exam City
preferences for 1) Visakhapatnam 2) Vijayawada 3) Berhampur 4) Bhubaneswar 5) Hyderabad
Phase-I

Y S R COLONY, KHASPANAUPAD Y S R COLONY, KHASPANAUPAD

Permanent Address A, Santhabommali, Srikakulam, An Communication Address A, Santhabommali, Srikakulam, An
dhra Pradesh, NAUPADA, 532211 dhra Pradesh, NAUPADA, 532211

Nearest Police Station as per Nearest Police Station as per

KHASPANAUPADA KHASPANAUPADA
Permanent Address Communication Address

Permanent Domicile (Permanent Domicile of the districts of State(s)/UTs. The candidate shall produce ‘Domicile Certificate’
Domicile Category issued by any Gazetted Officer in Revenue Department or any other official authorised by the State Government of the particular
state/UT.)

Domicile State Andhra Pradesh Domicile District Srikakulam

Chest Size 85.0 cm Waist Size 32.0 cm Shoe Size 9 No.

Transaction Reference No. Application Fees Transaction Date Received Date

Exam Fee Payment Details
113624342730 Rs. 649 27-Jan-2025 08:49 27-Jan-2025 08:49
 DECLARATION BY THE CANDIDATE

I have read and understood all the instructions for filling this application form. Further, I declare that statements made in this application are correct. I
understand that I am liable to be disqualified at any stage, if the information given is found to be incorrect/incomplete/false. I will produce all original
certificates and statement of marks and three photocopies of each, duly attested by me, at the time of appearing in the Phase-II. I am willing to undergo
physical and medical test, at my own risk and will not be entitled for compensation for injuries if any, sustained during such test.I am aware that the
decision by President, CASB will be final and binding on me.

Candidate Photo Candidate Live Photo Paste your photo

Signature of the candidate Thumb Impression

Place: SANTHABOMMALI Date: 27-01-2025