GOVT OF INDIA, MINISTRY OF DEFENCE
ASC CENTRE (SOUTH) - 2 ATC, BANGALORE
PROFORMA FOR APPLICATION
To
The Presiding Officer,
Passport Size
Civilian Direct Recruitment Board,
Photograph Paste
CHQ, ASC Centre (South) – 2 ATC/ASC Centre (North)-1 ATC
Here
Agram Post, Bangalore -07
[Self Attested]
1. Post Applied for ____________________________________________________
2. Name of the Candidate (Full Name) ____________________________________________________
3. Mobile Number (Functional) ____________________________________________________
4. E-mail ID [Functional] ____________________________________________________
5. Aadhar No. ____________________________________________________
6. Father’s Name ____________________________________________________
7. Date of Birth [DD/MM/YYYY] ____________________________________________________
(As per Matriculation Certificate)
8. Correspondence Address : -
House No. / Street / Village ____________________________________________________
Post Office ____________________________________________________
District ____________________________________________________
State ____________________________________________________
Pin Code ____________________________________________________
9. Permanent Address : -
House No. / Street / Village ____________________________________________________
Post Office ____________________________________________________
District ____________________________________________________
State ____________________________________________________
Pin Code ____________________________________________________
10. Educational Qualification ____________________________________________________
(Matric / ITI / Diploma / 12th /
Graduation / Post Graduation)
11. Education Qualification
Ser Qualification Name of School/ Name of Board/ University % of Marks Remarks
No. Collage obtained
12. Gender (Male / Female / Other) ____________________________________________________
13. Category ____________________________________________________
(UR/SC/ST/OBC/EWS/PH/ESM/MSP)
14. If applied for the Post of Ex- Serviceman: ____________________________________________________
(Date of enrolment in Army/Navy/Air Force and date of retirement and attach copy of Discharge Book/ Certificate/ NCO)
15. If applied for the post in PH category :
Type of Disability Percentage of Disability Remarks
(OH / HH / VH / Mental illness / (40% and above)
Multiple disability)
Enclose Disability certificate issued by
CMO/ Civil surgeon of Govt hospital
certifying the disability.
16. Whether registered with any ____________________________________________________
employment exchange
(If yes, mention registration No. and ____________________________________________________
Name of employment exchange) ____________________________________________________
17. Whether employed in Central Govt Services Yes / No
(If yes, give details as per following format & attach serving certificate duly signed by HoD)
Name of employer Name of Post Date of Appointment Serving Since Office Address
18. Name of Stations, a candidate wishes to be posted, if selected in the order of preference: -
(a) 1st Choice ____________________________________________________
(b) 2nd Choice ____________________________________________________
(c) 3rd Choice ____________________________________________________
DECLARATION
I hereby certify that above particulars mentioned in the application are correct and true to the best of my knowledge
and belief. I understand that in the event of any information being found false or incorrect at any stage or not
satisfying the eligibility criteria according to the requirement to the advertisement, my candidature/appointment in
liable to be cancelled/ terminated. I am willing to serve anywhere. I agree that department has the right to transfer
me to anywhere in India.
Dated : _______________
Place :_______________ (Signature of the Candidate)
Enclosures: -
[i] Two Self Attested Photographs [Name & Father’s Name on the back side of photo]
[ii] One Self addressed registered envelope duly affixed with the appropriate postal stamps.
[iii] Self Attested copies of certificates [ ] Sheets.
[iv] Admit Card in duplicate.
GOVT OF INDIA, MINISTRY OF DEFENCE
ASC CENTRE (SOUTH) - 2 ATC, BANGALORE
ADMIT CARD
[IN DUPLICATE]
(Applicable wherever Physical/ Skill Test is mandatory)
Roll No ___________________________________________________________
(Not to be filled by candidate)
Passport Size
1. Name of candidate ___________________________________________________ Photograph Paste
Here
[Self Attested]
2. Father’s/Husband’s Name_____________________________________________
3. Date of Birth __________________________________________________________________________
4. Application Registration No ______________________________________________________________
(Not to be filled by candidate)
5. Exam Centre Allotted ____________________________________________________________________
(Not to be filled by candidate)
6. Category (UR/SC/ST/OBC/EWS/PH) _______________________________________________________
7. Schedule of Exam
Physical/ Skill Test - _________________________________________________________
(Date & Time of reporting at Examination Centre)
8. Candidates will report for written test as applicable along with original documents. Only after verification of
original documents and Biometric Attendance, candidate will be allowed to appear for test.
__________________
Signature of Candidate
GOVT OF INDIA, MINISTRY OF DEFENCE
ASC CENTRE (SOUTH) - 2 ATC, BANGALORE
ADMIT CARD
[IN DUPLICATE]
(Applicable wherever Physical/ Skill Test is mandatory)
Roll No ___________________________________________________________
(Not to be filled by candidate)
Passport Size
1. Name of candidate ___________________________________________________ Photograph Paste
Here
[Self Attested]
2. Father’s/Husband’s Name_____________________________________________
3. Date of Birth __________________________________________________________________________
4. Application Registration No ______________________________________________________________
(Not to be filled by candidate)
5. Exam Centre Allotted ____________________________________________________________________
(Not to be filled by candidate)
6. Category (UR/SC/ST/OBC/EWS/PH) _______________________________________________________
7. Schedule of Exam
Physical/ Skill Test - _________________________________________________________
(Date & Time of reporting at Examination Centre)
8. Candidates will report for written test as applicable along with original documents. Only after verification of
original documents and Biometric Attendance, candidate will be allowed to appear for test.
__________________
Signature of Candidate
GOVT OF INDIA, MINISTRY OF DEFENCE
ASC CENTRE (SOUTH) - 2 ATC, BANGALORE
ADMIT CARD
[IN DUPLICATE]
Roll No ___________________________________________________________
(Not to be filled by candidate)
Passport Size
1. Name of candidate ___________________________________________________ Photograph Paste
Here
[Self Attested]
2. Father’s/Husband’s Name_____________________________________________
3. Date of Birth __________________________________________________________________________
4. Application Registration No ______________________________________________________________
(Not to be filled by candidate)
5. Exam Centre Allotted ____________________________________________________________________
(Not to be filled by candidate)
6. Category (UR/SC/ST/OBC/EWS/PH) _______________________________________________________
7. Schedule of Exam
Written Test - _________________________________________________________
(Date & Time of reporting at Examination Centre)
8. Candidates will report for written test as applicable along with original documents. Only after verification of
original documents and Biometric Attendance, candidate will be allowed to appear for written test.
__________________
Signature of Candidate
GOVT OF INDIA, MINISTRY OF DEFENCE
ASC CENTRE (SOUTH) - 2 ATC, BANGALORE
ADMIT CARD
[IN DUPLICATE]
Roll No ___________________________________________________________
(Not to be filled by candidate)
Passport Size
1. Name of candidate ___________________________________________________ Photograph Paste
Here
[Self Attested]
2. Father’s/Husband’s Name_____________________________________________
3. Date of Birth __________________________________________________________________________
4. Application Registration No ______________________________________________________________
(Not to be filled by candidate)
5. Exam Centre Allotted ____________________________________________________________________
(Not to be filled by candidate)
6. Category (UR/SC/ST/OBC/EWS/PH) _______________________________________________________
7. Schedule of Exam
Written Test - _________________________________________________________
(Date & Time of reporting at Examination Centre)
8. Candidates will report for written test as applicable along with original documents. Only after verification of
original documents and Biometric Attendance, candidate will be allowed to appear for written test.
__________________
Signature of Candidate
DECLARATION BY OBC CANDIDATES ONLY
(Similar endorsement should be given in the caste certificate from the competent authority)
I __________________________________Son/Daughter/wife of Shri_____________________________.
Residence _____________________of Village/Town/City ____________________District _____________State
_____________hereby declare that I belong to the_____________community which is recognized as a backward
class by the Government of India for the purpose of reservation in service as per orders applicable to the concerned
State. It is also declared that I do not belong to persons/sections (Creamy Layer).
Place : _______________ (Signature of the Candidate)
Date: ________________ Name _________________________________
----------------------------------------------------------------------------------------------------------------------------------------------
FORM OF UNDERTAKING TO BE GIVEN BY CANDIDATES APPLYING
FOR CIVIL POSTS UNDER EX-SERVICEMEN CATEGORY
I understand that, if selected on the basis of the recruitment/examination to which this application relates,
my appointment will be subject to my producing documentary evidence to the satisfaction of the appointing
authority that I have been duly released/retired/discharged from the Armed Forces and that I am entitled to the
benefits admissible to Ex-Servicemen in terms of the Ex-Servicemen (Re-employment in Central Civil Services
and Posts) Rules, 1979, as amended from time to time.
I also understand that I shall not be eligible to be appointed to a vacancy reserved for Ex-Servicemen in
regard to the recruitment covered by this examination, if I have at any time prior to such appointment secured any
employment on the Civil side (including Public Sector Undertaking, autonomous Bodies/Statutory Bodies,
Nationalized Banks, etc.) by availing of the concession of reservation of vacancies admissible to Ex-Servicemen.
Date : ______________
Place: ______________ (Signature of Candidate)
