AMAS TRG

PERSONAL INFORMATION QUESTIONNAIRE (PIQ) RECENT

PASSPORT
1. Selection Board (No. & Batch No. Chest No. Roll No. Contact No SIZE COLOR
Place) PHOTO

2. Name in CAPITALS (As in matriculation certificate) ____________________________________

3. Father’s Name. ____________________________________

4. (a) Place of Maximum Residence (Place, District, ____________________________________

State) (With approximate population of the place) ____________________________________
(b) Place of Present Residence (Place, District, ____________________________________
State) (With approximate population of the place) ____________________________________
(c) Place of Permanent Residence (Place, District, ___________________________________
State) (With approximate population of the place) ____________________________________
(Whether District HQ or not) ____________________________________

5. Fill in the details below:-

State & District Religion Whether Mother Tongue Date of Birth Married/Single/Widower
SC/ST/OBC/Gen.

6. (a) Parents alive -- Yes/No

(b) If not alive, your age at the time of Mother’s / Father’s death _________________________
(c) Parent’s / Guardian’s and siblings’ occupation/income (as applicable):-
Particulars Education Occupation Income per
month
Father
Mother
Guardian
Elder Brother/ Sister
Elder Brother/ Sister
Younger Brother/ Sister
Younger Brother/ Sister

7. Educational Record (Commencing from Matriculation/Equivalent Examination) :-

Qualificatio Full Name of Institution Board/University Year Div & Medium of Boarder/ Outstanding
n acquired Marks % instruction Day achievement, if
Scholar any
Matric/
Hr. Sec.
10+2
equivalent
Graduation

Post
Graduation
8. Age (Years & Months) Height (in Metre) Weight (in Kg)
_________________ _____________ ____________

9. Present Occupation and personal monthly income, if any _____________________________

10. (a) NCC Training Yes/No

(b) If Yes, Total Training (Give detail below):-
Total Training Wing Division Certificate obtained

11. (a) Participation in Games and Sports:-

Games/Sports Period of duration of Represented Outstanding
participation School/College/University/Other Achievement, if any

(b) Hobbies/Interests __________________________________________________________

(c) Participation in extra-curricular activities:-
Name of Activity Group Duration of Participation Outstanding achievement, if
any

(d) Position or responsibility/Officers held in NCC/scouting ______________________________

Sports Team/Extra-Curricular group and other fields_________________________________

12. (a) Nature of commission ______________________________________________________

(b) Choice of service ______________________________________________________

13. Number of chances availed for commission in all three service __________________________

14. Details of all previous interviews, if any (Army/Navy/Air Force Selection Boards)
S. No. Type of Entry SSB No. & Place Date Chest No. /Batch Result
No.

SIGNATURE OF CANDITATE__________________ DATE ______________

 FOR SERVICE PERSONNEL ONLY

Name in capital………………………………………………………………………………………….

Candidate’s Batch & Chest No…………………………………………………………………………

Personal No…………………..Rank………….Medical Category………………………………….

Date of Birth………………………Unit / Unit Address.........................................................................

Service Record (From the date of enrolment)

Rank Year of Name of Outstanding Achievement, Remarks

Appointment Employment in the if any
Rank

Record of operational service, if any

Locality of Period Outstanding Achievement, Remarks

operational if any
service From To

Course attended at Army/ Navy/ Airforce/ School of instructions:-

Course attended School of instruction Duration of training Result, if any Remarks