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AS PILOT IN EXECUTIVE BRANCH OF THE INDIAN NAVY (FOR MALE CANDIDATES ONLY) Paste self
attested recent
passport size
Regd No ………………………………… (For Official use only) colour
photograph
1. Applying for Course _________________________ (Do not staple)
2. Name in BLOCK Capitals as in Matriculation Certificate:-
4. Father’s Name:-
5. Father’s Occupation/Designation........................................................................................
6. Permanent Address:-
District
State Pin Tele
7. Correspondence Address:-
District
State Pin Mobile
Email
8. Nationality: 9. Domicile:
10. Date of Birth (DD/MM/YYYY)
11. Marital Status: Married Unmarried
12. Details of Marks Secured in Graduation and Above: -
Exam Semester/Year Wise Marks Secured
Passed Semester Marks Maximum % Marks Semester Marks Maximum % Marks
/ Year Obtained Marks / Year Obtained Marks
I . V .
II . VI .
III . VII .
IV . VIII .
18. Are you willing to volunteer for Executive (General Service), if not qualified PABT/Aviation medicals: Yes No
19. 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
1. I, hereby, declare that I am unmarried male, 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.
2. 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.
3. I fully understand that in the event of any information being found false or incorrect, action can be taken against me.