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Application Form For Matric Recruit Mr/Nmr-02/2015 Batch

The document is an application form for a Matric recruit batch in the Indian Navy in 2015, filled out by Ashok Kumar with his personal details like name, date of birth, address, education qualifications, and declaration that he has never been arrested or involved in any criminal cases. Ashok Kumar provides his contact information, visible identification marks of a cut on his left hand second figure and right foot, and signs the form to apply for the naval recruitment batch.

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AshokKumar
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49 views

Application Form For Matric Recruit Mr/Nmr-02/2015 Batch

The document is an application form for a Matric recruit batch in the Indian Navy in 2015, filled out by Ashok Kumar with his personal details like name, date of birth, address, education qualifications, and declaration that he has never been arrested or involved in any criminal cases. Ashok Kumar provides his contact information, visible identification marks of a cut on his left hand second figure and right foot, and signs the form to apply for the naval recruitment batch.

Uploaded by

AshokKumar
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FORM FOR MATRIC RECRUIT MR/NMR- 02/2015 BATCH

(UNMARRIED MALE CANDIDATES ONLY)


FOR INDIAN NAVY OFFICE USE ONLY

Code No:

For Office use only:

Application No:
(Affix Photograph)

VALID / INVALID
C15212062717N
1. PERSONAL PARTICULARS AS IN MATRICULATION CERTIFICATE:
NAME:

ASHOK KUMAR

DATE OF BIRTH:

1997/07/01

FATHER'S NAME:

OM PRAKASH

PERCENTAGE :

81

2.NATIONALITY:

INDIAN

5. ADDRESS:

3.MARITIAL STATUS:

Unmarried

4.EMAIL: [email protected]

PERMANENT

PRESENT

VILL KEDARIPUR PO BIRAMPURDISTT LAKHIMPUR KHERI

VILL KEDARIPUR PO BIRAMPURDISTT LAKHIMPUR KHERI

DISTRICT

LAKHIMPUR

LAKHIMPUR

STATE

Uttar Pradesh

Uttar Pradesh

PINCODE

262727

262727

--NA--

8447058065

TELEPHONE
MOBILE

6. EDUCATION PARTICULARS(HIGHLIGHTED SUBJECTS(10+2)):-Compulsory- and OptionalYear of Passing

Authority Conducting Exam

State from which Exam Passed

Serial No. of Certificate

Percentage

2012

STATE BOARD

Uttar Pradesh

1266025

81

7. NCC Certificate
8. HAVE YOU EVER BEEN ENROLLED IN ARMED FORCES BEFORE?
9. HAVE YOU BEEN DISCHARGED FROM ARMED FORCES BEFORE?
10. VISIBLE IDENTIFICATION MARKS (AT LEAST TWO):(a) LEFT HAND SECOND FIGURE CUT MARK

NO
NO
NO

(b) RIGHT FOOT CUT MARK

DECLARATION
1. I hereby declare that all the statements made in the application are true to the best of my knowledge and belief and the application has been filled
up by me.
2. I have never been debarred from appearing in any examination nor, have I ever been withdrawan from Defence Training Establishments on
disciplinary grounds, nor have I ever been arrested, prosecuted or convicted by criminal court or involved in any other case registered by the police. I
have not submitted more than one application for this batch.
3. I undertake not to make any claim for compensation if at any stage of selection, ineligibility for my candidature is detected and my candidature is
cancelled as a result thereof.
4. Any wilful misrepresentation of facts and concealment of information will result in the cancellation of the candidature and may debar me
permanently or for a specific period from applying for future examinations.

Place ___________
Date _____________

Signature of Parent

Signature of Applicant

IDENTIFICATION FORM
Name

ASHOK KUMAR

Father's name OM PRAKASH


Visible Identification Marks (at least two):(a) LEFT HAND SECOND FIGURE CUT MARK
(a) RIGHT FOOT CUT MARK

Application No. C15212062717N


Date of Birth

1997/07/01
(Affix Photograph)
Signature of Applicant

NOTE:
Please forward the print out of this application duly signed to the address mentioned in the advertisement along with relevant documents by ordinary
post.
December 22, 2014, 9:46 am

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