navy application

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22/10/2014 Untitled Document http://nausena-bharti.nic.in/th_multiqual_officer.php?applicationno=Quz53HZy0Reyrmt0A23M7Yup60A23M36P120A09T0A23M87QWEQ5YUpM7A3lM7A3l 1/1 APPLICATION FORM FOR Permanent Commission (PC) Education Jun 15 BATCH Please Attach Photo Here (UNMARRIED MALE CANDIDATES ONLY) FOR INDIAN NAVY OFFICE USE ONLY CODE NO. VALIDITY STATUS APPLICATION NO-PGD1510419822 Valid Invalid 1. CHOICE OF ENTRY- [1] PC(EDU) 2. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:- NAME SUDHAMALLA KIRAN NATIONALITY: INDIAN FATHER'S NAME RAMULU FATHER'S OCCUPATION/DESIGNATION:LABOUR DATE OF BIRTH 1991/02/15 DOMICILE: Andhra Pradesh GENDER M MARITIAL STATUS:Unmarried 7. ADDRESS: CORRESPONDENCE ADDRESS PERMANENT ADDRESS ADDRESS H.NO 6-8-88 SUBHASHNAGAR SIRICILLA KARIMNAGAR H.NO 6-8-88 SUBHASHNAGAR SIRICILLA KARIMNAGAR DISTRICT KARIMNAGAR KARIMNAGAR STATE Andhra Pradesh Andhra Pradesh PINCODE 505301 505301 TELEPHONE - - MOBILE 9700785703 --NA-- EMAIL [email protected] --NA-- 8.EDUCATION PARTICULARS: 8(a).Qual/Stream/YOP: B.Tech / Electronic and Communication / 2013 Percentage 65.67% Maximum Marks Marks Obtained Maximum Marks Marks Obtained 1st Semester 500 335 2nd Semester 500 335 3rd Semester 750 447 4th Semester 725 453 5th Semester 750 445 6th Semester 725 501 7th Semester 750 472 8th Semester 700 558 9. I HAVE NOT ATTENDED ANY SSB TILL TO DATE WITH THE ARMY/NAVY OR THE AIR FORCE. 10.Details of service under central/state Govt. if any (Candidates already in service should apply through proper channel and obtain NOC from the present employer.) Fill NA if not applicable:na DECLARATION 1.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. 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 B.Tech as on date. Note: Please forward complete printout of this application duly signed to the address mentioned in the advertisement along with the relevant documents as per advertisement. Place : ...................... Date: .................. Signature of Applicant: ..................................... October 22, 2014, 3:21 pm

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Navy Application

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Page 1: Navy Application

22/10/2014 Untitled Document

http://nausena-bharti.nic.in/th_multiqual_officer.php?applicationno=Quz53HZy0Reyrmt0A23M7Yup60A23M36P120A09T0A23M87QWEQ5YUpM7A3lM7A3l 1/1

APPLICATION FORM FOR Permanent Commission (PC) Education Jun 15 BATCH

Please Attach Photo Here

(UNMARRIED MALE CANDIDATES ONLY)FOR INDIAN NAVY OFFICE USE ONLY

CODENO. VALIDITY STATUS APPLICATION NO-PGD1510419822

Valid Invalid

1. CHOICE OF ENTRY- [1] PC(EDU) 2. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:-NAME SUDHAMALLA KIRAN NATIONALITY: INDIANFATHER'S NAME RAMULU FATHER'S OCCUPATION/DESIGNATION:LABOURDATE OF BIRTH 1991/02/15 DOMICILE: Andhra PradeshGENDER M MARITIAL STATUS:Unmarried

7. ADDRESS: CORRESPONDENCE ADDRESS PERMANENT ADDRESS

ADDRESS H.NO 6-8-88 SUBHASHNAGAR SIRICILLAKARIMNAGAR

H.NO 6-8-88 SUBHASHNAGAR SIRICILLAKARIMNAGAR

DISTRICT KARIMNAGAR KARIMNAGARSTATE Andhra Pradesh Andhra PradeshPINCODE 505301 505301TELEPHONE - -MOBILE 9700785703 --NA--EMAIL [email protected] --NA--

8.EDUCATION PARTICULARS:8(a).Qual/Stream/YOP: B.Tech / Electronic andCommunication / 2013 Percentage 65.67%

Maximum Marks Marks Obtained Maximum Marks Marks Obtained1st Semester 500 335 2nd Semester 500 3353rd Semester 750 447 4th Semester 725 4535th Semester 750 445 6th Semester 725 5017th Semester 750 472 8th Semester 700 558

9. I HAVE NOT ATTENDED ANY SSB TILL TO DATE WITH THE ARMY/NAVY OR THE AIR FORCE.10.Details of service under central/state Govt. if any (Candidates already in service should apply through proper channel andobtain NOC from the present employer.) Fill NA if not applicable:na

DECLARATION1.I, hereby declare that I am unmarried male/female, governed by nationality condition as laid down by the Government of India and have neverbeen debarred from appearing at any examination. I have never been arrested/prosecuted and convicted by a criminal court or involved in any othercase 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 beinitiated 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 B.Tech as on date.

Note: Please forward complete printout of this application duly signed to the address mentioned in the advertisement along with the relevantdocuments as per advertisement.

Place : ...................... Date: .................. Signature of Applicant:..................................... October 22, 2014, 3:21 pm