APPLICATION FORM

AFCAT No.

Candidate
ID
180716
Candidate
Name
SARVAJEET KUMAR
Mobile /
Phone
9693108715, -
Date of
Birth
06 Feb 1993
Gender Male
Postal
Address
C/O JAGMOHAN MAHTO, MAHUA TOLI,
RATU ROAD, GPO- RANCHI,
JHARKHAND, 834001
Permanent
Address
VILLAGE- DUBEYTAHLE, PO+PS-
MANJHIAON, DISTRICT- GARHWA,
JHARKHAND
Father
Name
SITARAM THAKUR Mother Name KAMALA DEVI
Visible
Identification
Mark
CUT MARK ON CHEEK
Nearest
Railway
Station
RANCHI
Married No
Appeared
GATE
(Year/Marks)
No
10+2 DETAILS
Pecentage 58
Marks in
Maths
63
Marks in
Physics
51
QUALIFICATION DETAILS
Graduate Post Graduate
College ANNAMALAI UNIVERSITY
University ANNAMALAI UNIVERSITY
Marks in
Maths
N/A
Marks in
Physics
N/A
Discipline All
Passout Date 15/05/2013
Pecentage 62
Backlogs 0
SUBJECTS STUDIED
Graduate Post Graduate
(L 01) Physics / Engineering Physics
(L 02) Mathematics / Engineering Mathematics
(L 03) Engineering Graphics / Engineering Drawing
(L 04) Electrical Engineering / Electrical technology

(L 07) Digital Electronics / Basic Electronic
(L 12) Electronic Circuit Design
(L 15) Instrumentation
(L 18) Electronic Devices
COURSE'S IN ORDER OF PREFFERENCE
[1] 197/15T/SSC/M/W AE (L), [2] 197/15T/PC/M AE (L), [3] 198/15F/SSC/M F(P), [4] 197/15G/SSC/M
(Adm)
CHOICE OF AFCAT CENTER IN ORDER OF PREFFERENCE
[1] Kolkata, [2] Patna, [3] Kalaikunda (Kharagpur), [4] Salua (Kharagpur), [5] Jamnagar
CHOICE OF AFSB CENTER
[1] None
DECLARATION
1. I hereby declare that all the statements made in the applications are true to the best of my
knowledge and belief.
2. I have never been debarred from appearing in any examination nor, have I ever been withdrawn from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.
3. I undertake not to make any claim for compensation if at any stage of my selection, my ineligibility for
candidature is detected and my candidature is cancelled as a result thereof.
4. This is the only application submitted by me.
5. Any willful misrepresentation of facts and concealed of information will result in the cancellation of the
candidature and may debar permanently or for a specified period from applying for future courses
6. Certified that I have read and understood the advertisement and fulfill the stipulated eligibility criteria.
I understand that my candidature is liable to be cancelled at any stage in case any discrepancy is
noticed.
7. No change in application is permitted after submission.
8. For Air Warriors, recommendation of BoO is mandatory and they are to carry duly recommended
application by BoO for AFSB testing.
9. Website is to facilitate the candidates for applying online. However, the rules will be governed by the
advertisement published for the course/ courses applied for.
Place :- ----
Date :- ----
Not Available
Thumb Impression

Signautre