6/5/2021 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.
0221AL0031965

Personal Information
Candidate Name SHIVAM TIWARI

Candidate's Father Name SURESH TIWARI

Candidate's Mother Name SHUSHMA TIWARI

E-mail Id shiwam575@gmail.com

Mobile Number 9340819461

Nationality Indian

Date of Birth(DD/MMM/YYYY) 01/Oct/1999

Marital Status Unmarried

Gender Male

Identification Mark mole on forehead

CPSS | PABT Status N_A

Airmen No

valid CPL No

Communication Address
Correspondence Address :

GRAM/POST - DHAWATIWARIYAN, TAH.- HANUMANA ,

Rewa, Madhya Pradesh, 486335

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Nearest Railway Station

REWA

Permanent Address :

GRAM/POST - DHAWATIWARIYAN, TAH.- HANUMANA ,

Rewa, Madhya Pradesh, 486335

Nearest Railway Station

REWA

Qualification Information
10+2(HSC)
Gross Percentage 62

Physics Percentage 56

Maths Percentage 70

Graduate (Degree Name - BTech)

College TECHNOCRATS INSTITUTE OF TECHNOLOGY BHOPAL

University RAJIV GANDHI PROUDYOGIKI VISHWAVIDYALAYA

Maths Percentage N/A

Physics Percentage N/A

Discipline Electrical Engineering

Passout Date(DD/MM/YYYY) 30/06/2021

Percentage 83

Backlogs No

Course Preferences
      [1]212/22F/SSC/M&W Flying      

      [2]211/22G/PC/M Administration      

      [3]211/22G/SSC/M&W Administration      

      [4]211/22T/PC/101AEC/M Aeronautical Engineer

(Electronics)      

      [5]211/22T/SSC/101AEC/M&W Aeronautical Engineer

(Electronics)      

AFCAT Exam State and corresponding City Choices

First Preference Madhya Pradesh -> Bhopal

Second Preference Uttar Pradesh -> Jhansi

Third Preference Madhya Pradesh -> Indore

Fourth Preference Madhya Pradesh -> Gwalior

Fifth Preference Madhya Pradesh -> Jabalpur

DECLARATION BY THE CANDIDATE

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I hereby declare that all statements made in this application are correct. I understand that I am liable to be disqualified at any stage,
if the information given is found to be incorrect/incomplete/false.
I undertake to produce all original certificates 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.

Signature of the candidate

Place:REWA

Date:2021-06-05

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