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INDIAN ARMY Directorate General Of Recruiting Application Form SHORT SERVICE COMMISSION (TECHNICAL)-42

(Course Commencing in April 2014)

Candidate's Report 1. Roll No. 2. Candidate's Name 3. Gender 4. Date of Birth 5. Nationality 6. Marital Status 7. Father's Name 8. Mother's Name 9. EmailID Address for Communication 10. Address 11. City 12. District 13. State 14. Mobile No. 15. PIN Permanent Address 16. Address 17. City 18. District 19. State 20. Mobile No. 21. PIN Qualification Details 22. Type of School 23. Qualification 24. Date of Joining 25. Date of Completion of Degree 26. Branch/Stream of Engineering 27. College Name 28. University Name 29. State in which University Located Basic Qualification Details 32. Is 10+2
Physics Chemistry Maths

737810 SANJAY SINGH VERMA M 08/03/1992 Indian Unmarried RAJENDRA PRASAD VERMA SUMAN VERMA (To Be attested by Gazetted Officer)

C-301,shree siddhi vinayak sankalp,Phase 2,,wadachiwadi road,undri Pune, Maharashtra Pune Maharashtra 9028747358 411028 C-301,shree siddhi vinayak sankalp,Phase 2,,wadachiwadi road,undri Pune, Maharashtra Pune Maharashtra 9028747358 411028 Others B.E. 01/09/2009 03/08/2013 Info Tech/Computer Sc & Engg/Computer Technology/M D. Y. PATIL COLLEGE OF ENGINEERING, AKURDI PUNE UNIVERSITY MAHARASHTRA True
Total Marks
100 100 100

Secured Marks
59 76 76

Engineering Marks Details

Semester TotalMarks MarksSecured Percentage CumulativePercentage CGPA PercentageConvertedToCGPA CGPAPercentage

1 2 3 4 5 6 7 8 650.00 650.00 750.00 750.00 750.00 750.00 750.00 750.00 325.00 341.00 401.00 397.00 413.00 425.00 422.00 444.00 50.00 52.46 53.47 52.93 55.07 56.67 56.27 59.20 50.00 51.23 51.98 52.22 52.79 53.43 53.84 54.51 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

Note :(a) The universities which have Grade Point system, need to convert Grades into %age of marks scored. Filling of cumulative %age of marks scored based 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. (b) For Candidates having only first year exams and not giving semester exams - Divide your first year marks in two equal halves and fill in 1st and 2nd semester. eg. : 700/1000 is to filled as 350/500 and 350/500.
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 Arms/Service in the interest of the organisation. 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 a result thereof. 6. This is the only application submitted for SSCT-42 course and 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 service training academy on disciplinary grounds. 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, 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 to join any other parallel entry i.e. from TGC to SSC (T), subject to availability of vacancies and agree to the terms and conditions of that entry. 13. 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. 14. In case of resignation from Academy, cost of training will be paid by me. 15. This application is accepted provisionally subject to meeting eligibility criteria. Note : 1. After submitting online application candidates are requested to obtain two copies of application print out. One copy of print out application duly signed and affix photo attested by Govt. officer thereon along with the required certificates in original and photo copy are to be carried to the selection centre by the candidate. Original will be returned after verification by the selection centre. Second copy of print out of online application is to be retained by the candidate for his reference. No need to send any hard copy to DG Recruiting / Recruiting Directorate. In case of colleges having grade point system, a certificate as below signed by the college principal will be carried by the candidate to the selection centre without fail :It is certified that Ms______________ has obtained cumulative grade X which is equivalent to Y% as per university/college rules. If candidate does not carry the above said documents to the Selection Centre for interview, his candidature will be cancelled. 2. It may be noted that depending upon the total number of applications received by this office for SSC(Tech)-42 / SSCW(Tech)-13 course, Recruiting 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. NO DEVIATION FROM THE NOTIFIED QUALIFICATION/STREAM IS ACCEPTABLE. CLAIMS OF COURSE CONTENT/SIMILAR STREAM WILL NOT BE ACCEPTED. 4. Any wrong details filled in above application will lead to cancellation of the candidature and suitable action will be taken against the candidate. 5. Applying second time on line or by post for SSC(T)-42 Course will lead to cancellation of candidature.

Place : Date : Signature of Applicant

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