Registration Date:16-08-2015 03:11 PM Print Date:19-11-2017 05:40 AM

INDIAN ARMY
Directorate General of Recruiting
SSC(Tech)-50/135778

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Personal Details
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1. Roll No SSC(Tech)-50/135778
2 Course Applied For : SSC(Tech)-50
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3. Candidate's Name (As per Matric ANOOP KUMAR SINGH

Certificate)
4. Father/Guardian Name MOOL SINGH
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5. Mother's Name SUSHEELA DEVI

6. Date of Birth (As per Matric Certificate) 15-02-1992
7. Nationality INDIAN
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8. If Other Nationality
9. Marital Status Unmarried
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10. Gender Male

11. Mobile No 7827676630
12. Email Address aksinghinbox@gmail.com
13. Aadhar XXXXXXXX5557
14. Permanent Address Correspondence Address
Address B-253, 3rd Floor, Address B-253, 3rd Floor,
Mohan Garden Mohan Garden
Extension, Uttam Extension, Uttam
Nagar Nagar
City / Town / Village New delhi City / Town / Village New delhi
State Delhi State Delhi
District Delhi District Delhi
PIN 110059 PIN 110059
15 SSB Details
(a) Entry (b) Location (c) Year/Month (d) Result
Naval Entries BHOPAL September-2013 Screened out
Registration Date:16-08-2015 03:11 PM Print Date:19-11-2017 05:40 AM

INDIAN ARMY
Directorate General of Recruiting
SSC(Tech)-50/135778

SSC(NCC) Bengaluru July-2014 Screened out

SSC(NCC) Bengaluru December-2014 Screened out
SSC(NCC) Bengaluru December-2015 Screened out
SSC(NCC) ALLAHABAD June-2016 Screened out
Air Force Entries MYSORE December-2016 Screened out

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SSC(NCC) Bengaluru December-2016 Screened out
Air Force Entries VARANASI July-2017 Screened out

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16 Education Details
(a) Type of School KENDRIYA VIDHYALAYA
(b) Roll No of 10+2 Examination OR Diploma 4603778
(c) Whether Diploma holder or not No
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(d) Aggregate % of Marks Obtained in Class 59.20
XII
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(e) Engineering Stream Applied For Electrical/Electrical & Electronics

(f) Specified Stream Electrical & Electronics
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(g) Date Of Joining Engineering Course 07-09-2008

(h) Date of Completion of Engineering 26-04-2013
(i) Name of College/Institute KCG COLLEGE OF TECHNOLOGY
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(j) Name of University ANNA UNIVERSITY

(k) Type of University State University
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(l) State in which University Located Tamil Nadu

17 Marks obtained in PCM in Class XII
Subject Total Marks Marks Obtained Percentage
Physics 100.00 72.00 72.00
Chemistry 100.00 59.00 59.00
Mathematics 100.00 40.00 40.0
Cumulative Percentage 57.00
18. Marks/Grades obtained in Graduation
Semester / Year Total Marks Marks Scored % of Marks Cumulative % of
Marks scored
Semester 1 100.00 60.00 60.00 60.00
Semester 2 / 100.00 63.00 63.00 61.50
Year 1
Semester 3 100.00 56.00 56.00 59.67
Semester 4 / 100.00 56.00 56.00 58.75
Year 2
Semester 5 100.00 59.00 59.00 58.80
Registration Date:16-08-2015 03:11 PM Print Date:19-11-2017 05:40 AM

INDIAN ARMY
Directorate General of Recruiting
SSC(Tech)-50/135778

Semester 6 / 100.00 53.00 53.00 57.83

Year 3
Semester 7 100.00 66.00 66.00 59.00
Semester 8 / 100.00 71.00 71.00 60.50
Year 4
Note

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The Universities which have a ‘Grade Point’ system, need to convert their Grades into
percentage of marks; failing which the application will be rejected.

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19. Certificates attached with application form:-
(a)
(b)
(c)
(d)
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Declaration
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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.
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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
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by Police.
5. I undertake not to make any claim or compensation if at any stage of selection, my
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ineligibility is detected and my candidature is cancelled as a result thereof.

6. This is the only application submitted for SSC(Tech)-50 and any duplicate application if
detected at any stage, 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 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.
Registration Date:16-08-2015 03:11 PM Print Date:19-11-2017 05:40 AM

INDIAN ARMY
Directorate General of Recruiting
SSC(Tech)-50/135778

14. This application is accepted provisionally subject to meeting eligibility criteria.

Declaration :
1. I affirm that all information supplied by me as above is true and correct, and I agree
that no change in particulars once filled by me will be permitted, I also fully understand that if
at any stage, it is discovered that any attempt has been made by me to wilfully conceal or

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misrepresent the facts, my candidature may be summarily rejected or employment terminated.

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2. I have read the notification for this entry and I agree to abide by all terms and
conditions as specified there in.
Place: AN
Date:30-08-2017 03:02 PM
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Signature of Applicant

Note
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1. After applying online, candidates are requested to take a print out, paste her attested
photograph in the space provided, sign it in blue ink in the space provided and carry the
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application without fail along with the original certificates the certificate from the college
principal regarding conversion of cumulative grade in %age of marks and with a valid
proof of identity to the Selection Centre when called for the interview. If candidate does
not carry the above said documents to the Selection Centre for interview, her
candidature will be cancelled.(No need to send printout of application to Recruiting
Directorate).
(a) 2 sets of photocopy of DOB/Matriculation Certificate.
(b) 2 sets of photocopy of Education Qualification Certificate/Marksheets.
(c) 2 sets of photocopy of the valid ID proof.
(d) 20 copies of self attested PP size photograph will also be carried alongwith
the application form.
2. It may be noted that depending upon the total number of applications received by this
office,(Recruiting Directorate reserves the right to short list and to fix cut off
percentage of marks for SSB interview). No representation will be entertained in this
aspect.
3. It may be Noted that candidates must apply strictly as per the notify stream of
Engineering as per Para 3 of Notification and equivalent stream are not allowed /
permitted .
4. Any wrong details filled in above application will lead to cancellation of the candidature
and suitable action will be taken against the Candidate.
Registration Date:16-08-2015 03:11 PM Print Date:19-11-2017 05:40 AM

INDIAN ARMY
Directorate General of Recruiting
SSC(Tech)-50/135778

5.Submission of multiple applications for SSC(Tech)-50 will lead to cancellation of

candidature.
CERTIFICATE BY PRINCIPAL/HEAD OF THE TECHNICAL INSTITUTIONS TO BE
SUBMITTED BY FINAL YEAR/SEMESTER CANDIDATES
Certified that Shri _________________________________ S/o _______________ Date of

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Birth _________________ is studying in final year/final semester of B.E/B.Tech
_______________________ (Branch of Engineering) in this University/College/lnstitute and

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her final year/semester examinations will be over by _______________________(Date) .

Place:______________
AN Signature:______________
Date: _______________ Designation:______________
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Note: Certificate signed by Heads of Departments will not be acceptable.

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