INDIAN ARMY

DIRECTORATE GENERAL OF RECRUITING

APPLICATION FORM FOR

TECHNICAL GRADUATE COURSE-121(TGC-121)
(Commencing July 2015)
1. Roll No.
2. Post Applied For
3. Candidate's Name
4. Father's Name
5. Mother's Name
6. Date of Birth
7. Nationality
8. Marital Status
9. Gender
10. Mobile No.
11. Email Address

505558
TGC 121
Shubham Aggarwal
Shailendra Kumar Aggarwal
Manju Aggarwal
08/04/1994
INDIAN
Unmarried
Male
9897252065
shubham.aggarwal@hotmail.com

12. Permanent Address

13. Correspondance Address

60/2 Govind Garh, SBI Colony,

Dehradun,
Dehradun,
Uttaranchal-248001

14. SSB History:

SNo.
1
2
3

To Be attested by
Gazetted Officer

60/2 Govind Garh, SBI Colony,

Dehradun,
Dehradun,
Uttaranchal-248001

Entry
NDA
TES
TES

15. Educational Details:

15(a) Type of School
15(b) Roll No of 10+2 Examination/Diploma
Roll No
15(c) Education Qualification
(B.E/B.Tech/B.Arch/M.Sc Comp Sc)
15(d) Aggregate % age of Marks Obtained in
Class XII
15(e) Whether done Diploma
15(g) Branch/Stream of Engineering in
B.E/B.Tech
15(h) Stream as in Degree/Semester Marksheet
15(i) Date of Joining Engineering College

Location
Varanasi
Allahabad
Allahabad

Others
T/7334/117
B.Tech

92.5
No
Mechanical
Mechanical Engineering
08/08/2011

Year/Month
2011
2011
2012

15(j) Expected Date of Completion of Degree

15(k) Name of College/Institute
15(l) Name of University
15(m) Type of University (Central
University/State University/Deemed/Private)
15(n) State in which University Located
15(o) Gate Score
15(p) Valid Upto
15(q) Marks Obtained in PCM in Class XII
Subject

06/30/2015
GB Pant Engineering College
Uttarakhand Technical University
State University
Uttaranchal
0.00
-

Total Marks

Physics
Chemistry
Maths/Biology
Cumulative Percentage

100
100
100
93.33

Obtained Marks

Percentage

94
94
92

94.00
94.00
92.00

16. Marks/Grade Obtained (whichever applicable) In Graduation

Semester
1
2
3
4
5
6

Total Marks
950
1050
1000
1000
1000
1000

Obtained Marks

Percentage

Cumulative Percentage

697
801
661
721
768
844

73.37
76.29
66.10
72.10
76.80
84.40

73.37
74.83
71.92
71.97
72.93
74.84

Note :(a). The universities which have Grade Point system, need to convert Grades into %age of marks scored. Filling of cumulative %age of marks

scored based 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
(b). For Candidates having only first year exams and not giving semester exams- Divide your first year marks in two equal halves and fill in 1st and
2nd semester. eg. 700/1000 is to filled as 350/500 and 350/500.
17. Certificates attached with application form :(a)
(b)
(c)
(d)

Declaration :1.
2.
3.
4.
5.
6.
7.
8.
9.

I have read and understood the instructions and undertake to abide by them.
I hereby declare that all statements made in the application are correct and true.
I undertake not to have any objections in the event of my final selection on allotment of any Arms/Service in the interest of the organisation.
I have never been debarred from appearing in any examination or UPSC and nor have I been arrested or convicted by a criminal court or involved
in any other case registered by Police.
I 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.
This is the only application submitted for TGC-121 course and any duplicate application if detected at any stage, my candidature be cancelled.
Any misinterpretation and wrong declaration/ concealment of information in the application will render my candidature to be cancelled and I may
be debarred from this course.
I have never been withdrawn from NDA, IMA or OTA or any service training academy on disciplinary grounds.
I am employed with ________________________ & I have informed my employer in writing that I am applying for commission in the Army.

10. In the eventuality of being recommended by SSB I will have no objection to be medically examined by board of Male/Female doctors, provided a
lady medical officer is present (applicable only to lady cadets)

11. I undertake to be debarred & my candidature be cancelled, if at any stage of selection I indulge in any violation of local orders concerning

discipline aspects
12. I undertake to join any other parallel entry i.e. from TGC to SSC (T), subject to availability of vacancies and agree to the terms and conditions of
that entry
13. I undertake not to marry till I complete the full training at the training academy, in case inducted. I also understand that in case of my final
selection, my appointment will be provisional subject to satisfactory police and educational verification.
14. In case of resignation from Academy, cost of training will be paid by me.

15. This application is accepted provisionally subject to meeting eligibility criteria.

Signature of the candidate

Place & Date : Your Registration Date & Time:12/2/2014 2:24:24 PM

Your Application Submission Date & Time:12/2/2014 2:31:43 PM

Note :1.

2.
3.

4.
5.

After applying online, candidates are requested to take a print out, paste his attested photograph in the space provided, sign it in blue ink
in the space provided and carry the application without fail along with the original certificates 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 candidate does not carry the above said documents to the Selection Centre for interview, his candidature will be
cancelled. No need to send printout of application to Recruiting Directorate.
It may be noted that depending upon the total number of applications received by this office, Recruiting 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.
In case the engineering stream of the candidate is not listed in the vacancies notified and candidates desire to claim equivalence, they may
produce equivalence certificate of the concerned universities for the purpose and candidate will be permitted to appear interview at their
own risk. Recruiting Directorate will examine the case for acceptance based on the certificate issued by the concerned university for
equivalence.
Any wrong details filled in above application will lead to cancellation of the candidature and suitable action will be taken against the
candidate
Submission of multiple applications for TGC-121 will lead to cancellation of candidature.

CERTIFICATE BY PRINCIPAL/HEAD OF THE TECHNICAL INSTITUTIONS

INSTITUTIONS TO BE SUBMITTED BY FINAL YEAR/SEMESTER CANDIDATES

Certified that Shri ____________________________S/o ______________________ Date of

Birth__________________ is studying in final year/final semester of B.E/B.Tech
________________ (Branch of Engineering) in this University/College/Institute and his final
year/semester examinations will be over by 01 July 2015

Place :_______________
Date :________________

Seal

Signature_________________
Designation _________________

Note: Certificate signed by Heads of Departments will not be acceptable.