12/10/2019 Application Form Preview

A F C AT A P P L I C AT I O N F O R M

INDIAN AIR FORCE

PEOPLE FIRST MISSION ALWAYS

Application Details for Career Air Force

Registration No. 0120AL0034558

Personal Information
Candidate Name Shivani Verma

Candidate's Father Name Rajesh Verma

Candidate's Mother Name Neelam Verma

E-mail Id vshivani073@gmail.com

Mobile Number 9532152027

Nationality Indian

Date of Birth(DD/MMM/YYYY) 23/Mar/1998

Marital Status Unmarried

Gender Female

Identi cation Mark Mole on the lower lip

CPSS | PABT Status N_A

Airmen No

valid CPL No

Communication Address
Correspondence Address :

159/10 JK COLONY,JAJMAU,KANPUR-208010, Kanpur,

Uttar Pradesh, 208010

Nearest Railway Station

KANPUR CENTRAL

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Permanent Address :

159/10 JK COLONY,JAJMAU,KANPUR-208010, Kanpur,

Uttar Pradesh, 208010

Nearest Railway Station

KANPUR CENTRAL

Quali cation Information

10+2(HSC)

Gross Percentage 89

Physics Percentage 85

Maths Percentage 78

Graduate (Degree Name - BTech)

College Madan Mohan Malviya University of Technoogy

University Madan Mohan Malviya University of Technology

Maths Percentage N/A

Physics Percentage N/A

Discipline Electrical Engineering

Passout Date(DD/MM/YYYY) 25/06/2020

Percentage 65

Backlogs No

Course Preferences
        [1]209/21F/SSC/M&W Flying      

      [2]208/21G/SSC/M&W Administration      

      [3]208/21G/SSC/M&W Logistics      

      [4]208/21T/SSC/M&W Aeronautical Engineer

(Electronics)      

AFCAT Exam City Choices

First Preference Gorakhpur

Second Preference Kanpur(UP)

Third Preference Lucknow

Fourth Preference Allahabad

Fifth Preference Varanasi

DECLARATION BY THE CANDIDATE

I hereby declare that all statements made in this application are correct. I understand that I am liable to be disquali ed at any
stage, if the information given is found to be incorrect/incomplete/false. I undertake to produce all original certi cates and
statement of marks at the time of appearing in the Selection test. 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.

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Signature of the candidate

Place:KANPUR

Date:2019-12-10

impression

 H O M E ( . / E X A M - C AT E G O R Y ) P R I N T A P P L I C AT I O N F O R M

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