INDIAN ARMYDIRECTORATE GENERAL OF RECRUITING

APPLICATION FORM FORTECHNICAL GRADUATE COURSE-120(TGC-120)

(Commencing January 2015)

1. Roll No. 543809

2. Post Applied For TGC 120

3. Candidate's Name Arpit khanna

4. Father's Name kishore kumar khanna

5. Mother's Name Rajni khanna

6. Date of Birth 25/07/1988

7. Nationality INDIAN

8. Marital Status Unmarried

9. Gender Male

10. Mobile No. 9845353818

11. Email Address er.arpit.khanna@gmail.com

To Be attested byGazetted Officer

12. Permanent Address 13. Correspondance Address106-D greater akash colony, AJR 1/2 JAYPEE COLONY,bareilly, shahabad/chittapur,Bareilly, gulbarga ,Uttar Pradesh-243112 Karnataka-585229

14. SSB History:SNo. Entry Location Year/Month

15. Educational Details:15(a) Type of School Others

15(b) Roll No of 10+2 Examination/DiplomaRoll No

0494875

15(c) Education Qualification(B.E/B.Tech/B.Arch/M.Sc Comp Sc)

B.Tech

15(d) Aggregate % age of Marks Obtained inClass XII

61.4

15(e) Whether done Diploma No

15(g) Branch/Stream of Engineering inB.E/B.Tech

Mechanical

15(h) Stream as in Degree/Semester Marksheet MECHANICAL ENGINEERING

15(i) Date of Joining Engineering College 07/10/2006

15(j) Expected Date of Completion of Degree 06/08/2011

15(k) Name of College/Institute INTITUTE OF ENGINEERING ANDTECHNOLOGY SITAPUR

15(l) Name of University UTTAR PRADESH TECHNICAL UNIVERSITY

15(m) Type of University (CentralUniversity/State University/Deemed/Private)

State University

15(n) State in which University Located Uttar Pradesh

15(o) Gate Score 0.00

15(p) Valid Upto -

15(q) Marks Obtained in PCM in Class XII

Subject Total Marks Obtained Marks PercentagePhysics 100 67 67.00Chemistry 100 68 68.00Maths/Biology 100 63 63.00Cumulative Percentage 66.00

16. Marks/Grade Obtained In Graduation

Semester Total Marks Obtained Marks Percentage Cumulative Percentage1 1000 537 53.70 53.702 1000 514 51.40 52.553 1000 549 54.90 53.334 1000 598 59.80 54.955 1000 598 59.80 55.926 1000 530 53.00 55.437 1000 654 65.40 56.868 1000 625 62.50 57.56

Note :-

(a). The universities which have ‘Grade Point’ system, need to convert Grades into %age of marks scored. Filling of cumulative %age of marksscored based on the Cumulative Grade at the end of third year/seventh semester/fourth year (as applicable) is compulsory; failing which theapplication will be rejected

(b). For Candidates having only first year exams and not giving semester exams- Divide your first year marks in two equal halves and fill in 1st and2nd semester. eg. 700/1000 is to filled as 350/500 and 350/500.

17. Certificates attached with application form :- (a) (b) (c) (d)

Declaration :-

1. I have read and understood the instructions and undertake to abide by them.

2. I hereby declare that all statements made in the application are correct and true.

3. I undertake not to have any objections in the event of my final selection on allotment of any Arms/Service in the interest of the organisation.

4. I have never been debarred from appearing in any examination or UPSC and nor have I been arrested or convicted by a criminal court or involvedin any other case registered by Police.

5. I undertake not to make any claim or compensation if at any stage of selection, my ineligibility is detected and my candidature is cancelled as aresult thereof.

6. This is the only application submitted for TGC-120 course and any duplicate application if detected at any stage, my candidature be cancelled.

7. Any misinterpretation and wrong declaration/ concealment of information in the application will render my candidature to be cancelled and I maybe debarred from this course.

8. I have never been withdrawn from NDA, IMA or OTA or any service training academy on disciplinary grounds.

9. I am employed with ________________________ & I have informed my employer in writing that I am applying for commission in the Army.

10. In the eventuality of being recommended by SSB I will have no objection to be medically examined by board of Male/Female doctors, provided alady medical officer is present (applicable only to lady cadets)

11. I undertake to be debarred & my candidature be cancelled, if at any stage of selection I indulge in any violation of local orders concerningdiscipline aspects

12. I undertake to join any other parallel entry i.e. from TGC to SSC (T), subject to availability of vacancies and agree to the terms and conditions ofthat entry

13. I undertake not to marry till I complete the full training at the training academy, in case inducted. I also understand that in case of my finalselection, my appointment will be provisional subject to satisfactory police and educational verification.

14. In case of resignation from Academy, cost of training will be paid by me.

15. This application is accepted provisionally subject to meeting eligibility criteria.

Signature of the candidate

Place & Date : -Your Registration Date & Time:6/9/2014 2:49:18 PM Your Application Submission Date & Time:6/15/2014 3:38:53 PM

Note :-1. After applying online, candidates are requested to take a print out, paste his attested photograph in the space provided, sign it in blue ink

in the space provided and carry the application without fail along with the original certificates the certificate from the college principalregarding conversion of cumulative grade into %age of marks and with a valid proof of identity to the Selection Centre when called forthe interview. If candidate does not carry the above said documents to the Selection Centre for interview, his candidature will becancelled. No need to send printout of application to Recruiting Directorate.

2. It may be noted that depending upon the total number of applications received by this office, Recruiting Directorate reserves the right toshortlist and to fix cut off percentage of marks for SSB interview. No representation will be entertained in this aspect.

3. In case the engineering stream of the candidate is not listed in the vacancies notified and candidates desire to claim equivalence, they mayproduce equivalence certificate of the concerned universities for the purpose and candidate will be permitted to appear interview at theirown risk. Recruiting Directorate will examine the case for acceptance based on the certificate issued by the concerned university forequivalence.

4. Any wrong details filled in above application will lead to cancellation of the candidature and suitable action will be taken against thecandidate

5. Submission of multiple applications for TGC-120 will lead to cancellation of candidature.

CERTIFICATE BY PRINCIPAL/HEAD OF THE TECHNICAL INSTITUTIONS INSTITUTIONS TO BE SUBMITTED BY FINAL YEAR/SEMESTER CANDIDATES

Certified that Shri ____________________________S/o ______________________ Date ofBirth__________________ is studying in final year/final semester of B.E/B.Tech________________ (Branch of Engineering) in this University/College/Institute and his finalyear/semester examinations will be over by 01 January 2015

Place :_______________ Signature_________________Date :________________ Seal Designation _________________

Note: Certificate signed by Heads of Departments will not be acceptable.