APPLICATION FORMAT
APPLICATION FOR 110th TGC
1. Indicate in the box percentage of aggregate marks of all
years/semesters obtained in the qualifying examination :
2. Full name (in Capitals) : ................................................
(Strictly as per Matriculation/Equivalent Certificate and there should be no deviation)
3. Father’s Name (in capital): ..................................................................
4. Date of Birth :........................................................................................
5. Postal Address with Telephone Number at which interview call letter is to be sent:
......................................................................................................................
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Dist...............State................. Pin Code....................E-mail ID ................... ......
6. Permanent Address ........................................................................................
......................................................................................................................
......................................................................................................................
Dist...............State.....................PinCode..........................Tele.....................
7. Nationality (a) Indian Yes /No. ............................................
b) Migrated from ............................................................. (fill only if not Indian)
8. Married ........................................................................... Yes/No
9. Branch/Subject for which applying:-
(a) TGC :- .....................................................................................................
(Branch of Engineering)
(b) AEC : .....................................................................................(Subject)
10. Educational Qualifications:
Qualification Name of Year of Division Year or %
Matriculation Institution Passing semester wise Percentage
onwards with marks obtained /
Branch of out of
Engg.
Degree/PG
Degree
11. Details of all previous interview in all three service (ARMY, A/F, NAVY) I
(Write NA if not appeared eartier.)
Type of Selection Batch/ Date of If recommended write ‘R’
Commission Centre. Chest No Reporting If screened out Write ‘S/o’
i.e. at SSB If not recommended write
NDA, TES, IMA, ‘N/R’
TGC, SSC, UES
or ABC
12. List of documents attached:
(a) ................................................................................................................
(b) ...............................................................................................................
(c) ................................................................................................................
DECLARATION
1. I hereby declare that all the statements made in the application are true to
the best of my knowledge and belief.
2. I have never been debarred from appearing at any examination nor have I
ever been with-drawn from NDA/IMA/OTA 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 there of.
4. This is the only application submitted by me for 110th TGC Entry course and
if any duplicate application is detected, my candidature be cancelled and I
may be debarred permanently from appliying for commission in the Armed Forces.
5. Any wilful misrepresentation of facts and concealment of information will
result in the cancellation of the candidature and may also debar a candidate
either permanently or for a specified period from applying for future courses.
6. In case of withdrawn from Academy Cost of trg@ Rs. 7075 per week will
be paid by me.
7. I undertake not to have any objections in the event of my final selection on
the allotment of any Arm/Service in the interest of service made to me prior
to passing out from IMA.
Date:
Place: (Signature of the Candidate)
