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For Academy Use Only: Personal Information Questionnaire

This document contains a personal information questionnaire for candidates applying to join the military academy. It requests details such as name, address, family background, educational qualifications, extracurricular activities, sports and hobbies. Medical and hostel fees are also noted. The document states that the academy is not responsible for any compensation for injuries sustained during the candidate's stay at the academy and that fees will not be refunded.

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Anuj
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60 views

For Academy Use Only: Personal Information Questionnaire

This document contains a personal information questionnaire for candidates applying to join the military academy. It requests details such as name, address, family background, educational qualifications, extracurricular activities, sports and hobbies. Medical and hostel fees are also noted. The document states that the academy is not responsible for any compensation for injuries sustained during the candidate's stay at the academy and that fees will not be refunded.

Uploaded by

Anuj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FOR ACADEMY USE ONLY

Date ofJolnln& Fees: II Bal Tel.No.· Medlc:al

Hostel No. Hostel Fees Date ofSSB

PERSONAL INFORMATION QUESTIONNAIRE


I. Selection Board (No. and Place) Batch No. Chest No. UPSC Roll No.

2. Name in CAPITALS (AS in the application fonn)

3. Father's Name

4. (a) Place of Maximum Residence

(b) Present �ddress (with approximate population


of the City/ Town/ Village)

(c) Permanent Address (with approximate population


of the City/ Town / Village)

(d) Whether DistrictHeadquarter or not

S. Fill in the Details below :


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

6. (a) Parents alive YES/NO


(b) If not alive, your age at the time of father's/mother's death
(c) Parents/ Guardians Occupation/ Income (as applicable)

Particulan Education Occupation Income per Month

Father
Mother
Guardians
7. Educational Record (Commencing from Matriculation/ Equivalent Examination) :-
Qualification Name ofInstitution Year Division & Medium of Boarder/ Outstandlo&
S.No. Day
Acquired Markso/•. Instructions achievement
Scholar lfaoy

(a) Matric /Hr. Sec.

(b) 10 + 2 Equivalent

(c) B.A./ B. Sc./ B.Com

(d) Professional
(a) No. of brothers and sisters
(b) Your ranking amongst brother/sister
(c) Education and Occupation of brother/sister
8. Age (Years, Months) _____ _ __ Height (in Meten) _ ____Weight (in Kgs.. J-----
9. Present Occupation and Personal Monthly Income, ifany _________________

JO (a) N.C.C. Training Yes/No


(b} Total Training (IfYes) (Give Details Below)

Total Tnlnln& \\1ns Division CertiOcate Obtained

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

Games/ Sportl Out1taadJa1 achievement Ir any

(b) H obbies/ Interest

(c) Participation in Extra-Curricular activities

Name or Group Activity Dundon or Participation Outstandlns achievement Ir any

(d) Position ofResponsibility/Offices held in NCC/Scouting/


Sports Team I Extra-Curricular Group and other fields :-

12. (a) Nature ofCommission

(b) Choice of Service

13. Number ofchances availed for Commission in all three services

14. Details oflast interview, ifany (Air/Navy/Anny/ Selection Board)

Date Recommended/Not
S. No. Type orEntry Place and SSB No. Batch and Cbm No. Recommended

The Academy II not raponalble ror any compensation to the Candidate or to his pardlan ror Injuries Ir any 1u1talned by a
Candidate durln& the period or stay at the Academy.

NO REFUND OF FEES
Signature

. ...

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