APPLICATION FORMAT FOR GRANT OF SHORT SERVICE COMMISSION

AS PILOT/OBSERVER INTHE INDIAN NAVY Paste your

recent colour
Regd. No........................................... ((For Official use only) photograph
(Do not staple)
1. Applying for Course _________________________ Branch________________________

2. Name in Block capitals as in Matriculation certificate:-

3. Expanded full name if abbreviated in Serial 2 above:-

4. Father’s Name:-

5. Father’s Occupation/Designation........................................................................................
6. Correspondence Address:-

District State
PIN Mobile: Tele :
EMAIL
7. Permanent Address:-

District
State PIN
8. Nationality: 9. Domicile

10. Marital Status: Married o Unmarried o 11. Gender: Male o Female o

12. Date of Birth (DD/MM/YY)

13. Marks secured in 10+2 level (Marks Obtained/Maximum marks) Physics Math.

14. Details of Marks Secured in Graduation and above: -

Exam Semester/Year wise Marks secured
Passed
Sem./ Marks Maximum % Marks Sem./ Marks Maximum % Marks
Year obtained marks Year obtained marks
I . V .
II . VI .
III . VII .
IV . VIII .
TOTAL MARKS AND OVERALL PERCENTAGE .

15. Are you willing to volunteer for Executive (General Service) if not qualified PABT/Aviation Medicals: - Yes o No o
16. Have you attended any SSB interview earlier :-.…...(If yes, give details for all earlier attempts)
…………………………………………………………………………………………………………………………………………………………

17. Details of Service under Central/State Govt., if any…………………………………………………………………………………….….

(Candidates already in service should apply through proper channel and obtain NOC from the present employer)

DECLARATION
18. I, hereby, declare that I am unmarried male/ female, governed by nationality condition as laid down by the Government of India and have
never been debarred from appearing at any examination. I have never been arrested/ prosecuted and convicted by a criminal court or involved in
any other case registered by the Police.
19. I, hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my knowledge and
belief.
20. I fully understand that in the event of any information being found false or incorrect, action can be taken against me.

Place: …………....…….. Signature......................................................

Date: .......................... Name of the Applicant...................................
 INSTRUCTIONS FOR FILLING UP OF APPLICATION FORMAT
1. Application will be accepted only after publication of advertisement for the concerned
entry in Employment News/National Daily

2. Read carefully concerned advertisement and apply on A4 size paper (typed) as per format.

3. The application is to be filled by the candidate in English and in BLOCK CAPITALS.

4. Candidates submitting more than one application will be disqualified.

5. Attach attested copy of class Tenth(X) certificate for date of birth verification.

6. Age (See Advertisement for exact block of dates) is as on joining the Naval Academy should
be between 19 to 23 years.

7. Application and enclosures to be properly tagged/stitched by thread to avoid loss of enclosure.

8. Darken the appropriate box with black ball point pen at serial 10, 11 & 15.

9. Applicants have option to opt for General Service (Executive Branch) subject to fulfilling
eligibility criteria in respect of educational qualification. Para 15 is only applicable in case
of candidates not qualifying PABT/Aviation Medicals.

10. It is mandatory to fill Branch and Course at para 1 of Application Format.

(Attested copies of mark sheet of each semester/year must be attached. In case evaluation is in grades,
certified equivalent marks to be indicated. Please attach extra sheet, if necessary).