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APPLICATION FORM FOR MALE CANDIDATES FOR SELECTION AS AIRMEN IN INDIAN AIR FORCE:FOR INTAKE 01/2020

Payment Status: Online Payment Success Registration No. 19030108743 Gender: Male

Candidate Name Snehasish Mohapatra Parent Name Jayadev Mohapatra Nationality Indian

Date Of Birth 22-12-2000 Marital Status UnMarried Qualification 12th

Aggregate % 67 Name Of Education CENTRAL BOARD OF English % 70

Board/Diploma Institute SECONDARY EDUCATION
Maths % 52

Physics % 66 Additional Marksheet No

Mobile No +917655987358 EMail Id mohapatra.snehasish786@gmail.com Aadhaar Card No 622850293075

Serving IAF NC(E) No NCC Certificate Holder No SOAFP Yes

Discharged from Forces/Govt. No Stream Applied Group X Identification Mark Black mole on left underarm
Org.
Candidate Height 170 cm

Exam City preferences for phase I Beherampura(Odisha) Bhubaneswar Kolkata Rourkela Sambalpur

ASC preferences for phase II 9 ASC, Bhubaneswar (Odisha) 4 ASC, Kolkata (West Bengal) 12 ASC, Secunderabad (Telangana)

Permanent Address Eranch,Eranch,Niali,Cuttack,Odisha,754105 Communication Address Eranch,Eranch,Niali,Cuttack,Odisha,754105

Chest Size 42 Inch Waist Size 34  Inch Shoe Size 9  No.

DECLARATION BY THE CANDIDATE Paste

I have read and understood all the instructions for filling this application form. Further, I declare that statements made in this application are correct. I understand that I am liable
to be disqualified at any stage, if the information given is found to be incorrect/incomplete/false. I will produce all original certificates and statement of marks and three your
photocopies of each, duly attested by me, at the time of appearing in the phase II. I am willing to undergo physical and medical test, at my own risk and will not be entitled for
compensation for injuries if any, sustained during such test.I am aware that the decision by President, CASB will be final and binding on me. Photo

Signature of the candidate Thumb Impression

Place:Puri

Date:06-01-2019

Preview/Print Application Form

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