APPLICATION FORM

APPLICATION FOR 126 GROUND DUTY OFFICERS’ COURSE FOR MEN / 19 SHORT SERVICE COMMISSION
FOR MEN / 35 SHORT SERVICE COMMISSION FOR WOMEN
(*Strike out whichever is not applicable)

FOR OFFICE USE FOR AIR HQ / AFSB USE

ONLY (COMD HQ)
CET ROLL NO CENTRE ALLOTTED AFSB CODE NO CHEST NO. (PH-I / PH-II)

1. NAME IN BLOCK CAPITALS AS IN MATRICULATION CERTIFICATE: Affix self attested

recent passport
size colour
2. FATHER’S NAME AS IN MATRICULATION CERTIFICATE: photograph
(DO NOT
STAPLE)
3. PERMANENT ADDRESS WITH PIN CODE AND TELE NO, IF ANY:

PI TELE
N

4. PRESENT ADDRESS WITH PIN CODE AND TELE NO, IF ANY: (FOR CORRESPONDENCE)

PI TELE
N

5. E-mail address ………………………………………………………. Mobile No……………………………………...

6. CHOICE OF CET CENTRE: 1…………………………..…………. 2………………………………………………..
7. DATE OF BIRTH (DD/MM/YY):
(As per matriculation / Equivalent Certificate)
8. MARITAL STATUS: SINGLE /MARRIED/WIDOW/DIVORCEE *
9. SEX: MALE / FEMALE *
10. Visible Identification Mark: ……………………………………………………. LEFT THUMB IMPRESSION FOR MEN / RIGHT
THUMB IMPRESSION FOR WOMEN
………………………………………………………………………………………..

11. Type of Commission: PC / SSC (M) / SSC (W) * (Men may choose both PC & SSC (M). SSC (W) for Women only)
12. Educational Qualifications:-
Marks obtained in
Qualification (Specify) and
Institution & Place of Study and University Subjects aggregate with percentage
Medium of Instruction
of marks & division

13. NCC Air Wing (Senior Division) ‘C’ Certificate ……………………….. YES / NO
14. Appeared / Did not appear in SSB earlier for ARMY / NAVY / AIR FORCE / COAST GUARD
15. I have read the instructions carefully before sending this application. I hereby declare that all the statements made in the
application are correct to the best of my knowledge and belief. I understand that any discrepancy found in the above information
will lead to cancellation of my candidature / debarment.

Date: ………………………….
Place: ………………………… Signature of Applicant