INDIAN ARMY

DIRECTORATE GENERAL OF RECRUITING

Application Form for TES-33

1. Roll No.
2. Post Applied For
3. Candidate's Name
4. Father's Name
5. Mother's Name
6. Date of Birth
7. Nationality
8. Marital Status
9. Gender
10. Mobile No.
11. Email Address

413681
TES-33
VAIBHAV GUPTA
MAHESH CHANDRA GUPTA
RANEE GUPTA
07/11/1997
INDIAN
UNMARRIED
Male
9899193704
ABHIGUPTAORAI@GMAIL.COM

12. Permanent Address

13. Correspondance Address

4,RAM CHARAN MARKET

C/O-ARVIND AGENCIES,
ORAI,
JALAUN,
UTTAR PRADESH-285001

14. SSB History:

SNo.
Entry

4,RAM CHARAN MARKET C/O-ARVIND AGENCIES,

ORAI,
JALAUN,
UTTAR PRADESH-285001

Location

15. Academic Details:

15(a) Education Qualification
15(b) Education Board
15(c) Type of School
15(d) 12th Class Roll No.

To Be attested by
Gazetted Officer

Year/Month

10+2
OTHERS
OTHERS
1356604

16 JEE(MAINS) Ranking / Score

16(a) Year in which appeared
16(b) JEE(MAINS) Score
16(c) JEE(MAINS) Rank
Subject
Physics
Chemistry
Mathematics

Percentage Obtained
89.00
92.00
96.00

Result

Aggregate Percentage

17 Applied for parallel NDA course

(NDA-134 course commencing in July 2015)

92.33
NO

18 If yes, NDA UPSC Roll No

Declaration :I affirm that all information supplied by me as above is true and correct, I also fully understand that if at any stage, it is discovered that any
attempt has been made by me to willfully conceal or misrepresent that facts, my candidature may be summarily rejected or employment terminated.

Signature of the candidate

Place & Date : Your Registration Date & Time:NOV 6 2014 6:36PM

Your Application Submission Date & Time:NOV 6 2014 6:47PM

Note :1.

2.
3.
4.

After submitting on online application, candidates are required to obtain two copies of printout of the application generated by the system. One
copy of the printout of application duly signed and affixed photograph attested by a Gazetted Officer of Central/State Govt. along with attested
copies of required certificates (i.e. 10th class certificate/mark sheet showing date of birth and 12th class certificate along with mark sheet) duly
attested by Gazetted Officer along with all the above certificates in original will be carried to the Selection Centre by the candidate for SSB
interview. The second copy of the print out of online application is to be retained by the candidate for his reference. Do not send any hard
copy/print out of application form to DG Rtg/Rtg Dte.
Any candidate who does not carry above mentioned documents for the SSB interview, his candidature will be cancelled. Applying second time
online (i.e. more than one application) will also lead to cancellation of the candidature.
It may be noted that depending upon the total number of online applications received by this office for 10+2 TES-33 course, Recruiting
Directorate reserves the right to shortlist and to fix cut off percentage of PCM marks for SSB interview. No representation will be entertained in
this aspect.
Any incorrect details filled in the above application will lead to cancellation and suitable action will be taken against the candidate.

Declaration :1.
2.
3.
4.
5.
6.
7.

I have read and understood the instructions and undertake to abide by them.
I hereby declare that all statements made in the application are correct and true.
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 organization.
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.
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.
This is the only application submitted for this course any duplicate application if detected, my candidature be cancelled.
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.
I have never been withdrawn from NDA, IMA or OTA or any service training academy on disciplinary grounds.

8.
9. I am employed with _____________ & I have informed my employer in writing that I am applying for commission in the 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.
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.