Application Form

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RTG DTE 6 Additional Directorate General Of Recruiting

Application to be filled only in Internet Explorer 6,7,8 ONLINE APPLICATION FORM SSC (Tech)-39 (Commencing in Oct 2012)
Paste passport size photo dully attested by Gazetted Officer on the application to be sent to recruiting Directorate and on the application to be carried to selection centre for interview by hand

Select your Gender

i j k l m n Male n Female j k l m

Personal Details Candidate Name pawan kumar thakur (As given in matriculation certificate) Date of Birth 27/08/1989 (dd/mm/yyyy) (As given in matriculation certificate) (Between 02 Oct 1985 to 01 Oct 1992) Father's Name Email ID
amar singh thakur

Nationality

i j k l m n Indian n Nepalese n Other j k l m j k l m

Marital Status Mother's Name

UNMARRIED rama thakur

(As given in matriculation certificate)

pthakur89@gmail.com

(As given in matriculation certificate) (Please enter the E-mail address you use frequently as this would be used for further communication) State District Pin
HIMACHAL PRADESH SHIMLA 171004
6 6

Permanent Address Address house no t 15 g

railway colony

City Mobile
c d e f g Click

shimla 09418316652

here if current/correspondence address different from Permanent Address

i j k l m n Yes n No j k l m

Previous Attempt(s) at SSB Appeared before in SSB? (Please Tick) SSB Allahbad Bhopal Bangalore Mysore Varanasi Dehradun Please provide Engineering College Details Qualification Select Branch/Subject Name of the College in which you studied State where univ. located Select your University from the list Batch & Chest Batch & Chest Batch & Chest # # #
10+2 tes26

ENGG GRAD (B.E./B.TECH./M.TECH.)

6 6

COMPUTER SCIENCE & ENGG/COMPUTER SCIENCE/M.SC COMPUTER lr institute of engg and technology HIMACHAL PRADESH HIMACHAL PRADESH UNIVERSITY, SHIMLA

6 Other University If your university is not in the list then please click on Other University Link and provide your university name

Date of completion of Degree/Completion of final year 31/07/2012 (dd/mm/yyyy) exam Recognised by Central Govt HRD i j k l m n Yes n No j k l m Ministry/UGC/AIU ? 12.Marks / Grade Obtain(whichever is applicable
b c d e f g Is

Appeared/Marks Pending % age of marks scored (if applicable) Total Marks Marks Scored %age Cumulative %age of marks scored (upto 2 decimals) Total Marks Marks Scored Cumulative %age SGPA (if applicable) CGPA/DGPA % age of (Cumulative) Marks based on Cumulative Grade /DGPA (upto 2 decimals)

Semester / Year

1st Semester 2nd Semester/1st Year

1300 1300

937 962

72.07 74.00

1300 1300

937 962

72.07 74.00

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Application Form

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3rd Semester 4th Semester/2nd Year 5th Semester 6th Semester/3rd Year 7th Semester 8th Semester/4th Year 9th Semester (Architecture Only) 10th Semester (Architecture Only)

1400 1200 1300 1300

1074 890 1003 1006

76.71 74.16 77.15 77.38

1400 1200 1300 1300

1074 890 1003 1006

76.71 74.16 77.15 77.38

Note :1. Filling of cumulative %age upto 2 decimal is compulsory.The Universities which have grade point system, need to convert Grades into %age of marks scored.Filling of final cumulative %age of marks scoredbased on the cumulative grade at the end of third year/seventh semester/fourth year (as applicable) is compulsory;failing which the application will be rejected. 2. Candidates who have been penalised with an 'Year Back/Failed' by one or more year during degree course are ineligible to apply. 13. Certificates: (a) (b) (c) Note 1. After applying online, candidates are requested to take a print out, paste his/her attested photograph in the space provided, sign it in blue ink in the space provided and send it along with attested copies of the required certificates to recruiting directorate by post. Incase of colleges having grade point system, a certificate as below signed by the college principal will be forwarded to Recruiting Directorate without fail :It is certified that Mr ------------has obtained cumulative grade 'X' which is equivalent to 'Y' % as per university/college rules. Candidates are also required to carry one more ink signed copy of the application, without fail along with the attested photograph pasted on it, all original certificates along with the certificate from the college Principal regarding conversion of cumulative grade into %age of marks and with a valid proof of identity to the selection centre when called for the interview. If a candidate does not send the said documents by the post to recruiting directorate and does not carry the above said documents to the selection center for the interview, his candidature will be cancelled. Applying second time on line will also lead to cancellation of candidature. 2. It may be noted that depending upon the total number of applications received by this office for TGC/SSC (T) Men course, recruitng directorate reserves the right to shortlist and to fix cut off percentage of marks for SSB interview. No representation will be entertained in this aspect. 3. Any incorrect details filled in above application will lead to cancellation of candidature and suitable action will be taken against the candidate SIGNATURE
b c d e f g I have read and understood the instructions and undertake to abide by the Terms and Conditions Cancel

Submit

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