Registration Date:17-02-2019 03:02 PM Print Date:08-08-2019 08:11 PM

INDIAN ARMY
Directorate General of Recruiting
SSC(NCC)-47/800818

NCC Application Details

MY
AR
Personal Details AN
1. Roll No SSC(NCC)-47/800818
2 Course Applied For : SSC(NCC)-47
DI

3. Candidate's Name (As per Matriculation ANKIT DIXIT

Certificate)
4. Father's/Guardian's Name AJAY DIXIT
IN

5. Mother's Name JYOTI DIXIT

6. Date of Birth (As per Matriculation 23-09-1996
Certificate)
IN

7. Nationality INDIAN
8. Nationality, if ‘Others’
JO

9. Marital Status Unmarried

10. Gender Male
11. Mobile No 9977712565
12. Email Address ankhushdixit@gmail.com
13. Aadhar No XXXXXXXX5392
14. (a) Permanent Address (b) Correspondence Address
Address Scheme no. 5 jda Address Scheme no. 5 jda
M.i.g_4,Vijay nagar M.i.g_4,Vijay nagar
City / Town / Village Jabalpur City / Town / Village Jabalpur
State Madhya Pradesh State Madhya Pradesh
District Jabalpur District Jabalpur
PIN 482002 PIN 482002
15 Previous SSB Attepmts (Do not write anything in column below, if Nil attempts
earlier)
(a) Entry (b) Selection (c) Batch/Chest (d) Reporting (e) Result
Centre No Date
16 (a) Education Qualification B.E./B.Tech/B.Arch/Msc
Registration Date:17-02-2019 03:02 PM Print Date:08-08-2019 08:11 PM

INDIAN ARMY
Directorate General of Recruiting
SSC(NCC)-47/800818

Computer (Apearing)
16 (b) Aggregate Marks in Graduation Exam
Year Total Marks Marks Obtained
Year I 100.00 72.00
Year II 100.00 69.00

MY
Year III 100.00 71.00
Year IV 100.00 79.00

AR
Total Aggeragate Marks 291.00
Out of Total Marks 400.00
Percentage of Aggregate Marks 72.75
17 Ward of Battle Casualty :
AN
Are you a Ward of Battle Casualty? No
18 Details Concerning NCC ‘C’ Certificate (Exempted, if Ward of Battle casualty) :-
DI

(a) Grading in NCC 'C' Certificate B

(b) NCC ‘C’ Certificate obtained from 4mpctr
IN

(c) NCC ‘C’ Certificate No 18/4555

(d) Date of issue of NCC ‘C’ Certificate 25-07-2019
Declaration
IN

1. I will not avail any SSB interview for the course SSC(NT)-111 as CDSE candidate for
OTA commencing in 01 APR 2020.
JO

2. I have read the course notification as well as the instructions for filling this application on
www.joinindianarmy.nic.in. I undertake to abide by all instructions /guidelines mentioned
therein.
3. I affirm that all information supplied by me as above is true and correct. I also fully
understand that if at any stage, it is discovered that any attempt has been made by me
to willfully conceal or misrepresent the facts, my candidature may be summarily rejected
or employment terminated. I also undertake not to make any claim or compensation, if at
any stage of selection, my ineligibility is detected and my candidature is cancelled as a
result thereof.

Place:
Date:12-07-2019 09:04 PM

Signature of Applicant
Registration Date:17-02-2019 03:02 PM Print Date:08-08-2019 08:11 PM

INDIAN ARMY
Directorate General of Recruiting
SSC(NCC)-47/800818

MY
AR
AN
DI
IN
IN
JO