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Defence Services Staff College, Wellington: (To Be Filled in Capital Letters As Per Matriculation (Or) X STD Mark Sheet)

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DEFENCE SERVICES STAFF COLLEGE, WELLINGTON

----------------------------------------------------------------------------
FOR OFFICE USE ONLY

1. Index No:

2. Accepted / Rejected :

3. Reason for rejection:

4. ROLL NO:
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APPLICATION FORM FOR THE POST OF

1. Name :
[To be filled in Capital letters as per Matriculation (or) X Std mark sheet] Paste a self-
attested passport
2. Father’s / Husband’s Name: size photograph

3. Date of Birth :
[Enclose Matriculation (or) X Std mark sheet]

4. Age as on last date for receipt of application: Yrs Months Days

5. Caste & Category : & UR / SC / ST / OBC / EWS

6. Category for which applied : UR / SC / ST / OBC / EWS / ESM / PwBD


[Enclose respective certificate copy & for ESM Discharge certificate copy & PwBD certificate copy]

7. Educational & Technical qualifications :


[Enclose respective certificate copies]
Class Year of Marks Total Marks Percentage Remarks
passing obtained
10th / SSLC /
Matriculation
12th / HSC

ITI

Diploma

8. Experience (if any) :


[Enclose proof]
-2-

9. In case, You are employed in Central/State Govt/PSU/Statutory body as permanent employee,


please provide following details:- [No Objection Certificate to be enclosed]
Date of Appointment: Name of Post:
Present post held: Present Pay & Level:
Name & Address of Office:

10. Mobile No or Contact Tele No:

11. Aadhaar Card No :


[Copy should be enclosed]

12. Address for Correspondence:-

Address Line1 :

Address Line2 : .

Taluk: District: .

Pin Code: State: .

13. Permanent Home Address (if different from Ser 9 above):- Same as above

Address Line1 :

Address Line2 : .

Taluk: District: .

Pin Code: State: .

14. E-mail ID :

It is certified that the above particulars are correct and true to the best of my knowledge
and belief and certificates submitted are genuine, if found false at any stage, my
candidature/services may be terminated without notice and I will be liable for legal
action/proceedings.

Place:

Date: (Signature of the candidate)


Duplicate Copy
ACKNOWLEDGEMENT / ADMISSION CARD Copy
(Sl No 1 to 4 to be filled by the applicant) (Sl No 5 & 6 to be filled be DSSC)

1. Post applied for

2. Name :
Paste a self-attested
3. Date of Birth : passport size
photograph
4. Aadhaar card No:

5. ROLL NO : .

6. Date and Time of Written Test:

7. Venue of Written Test: DSSC, WELLINGTON.

8. Instructions for written test will be forwarded alongwith this admission card.

Signature of Controlling Officer

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - -

Candidate Copy
ACKNOWLEDGEMENT / ADMISSION CARD
(Sl No 1 to 4 to be filled by the applicant) (Sl No 5 & 6 to be filled be DSSC)

1. Post applied for

2. Name :

3. Date of Birth : Paste a self-attested


passport size
4. Aadhaar card No: photograph

5. ROLL NO :

6. Date and Time of Written Test:

7. Venue of Written Test: DSSC, WELLINGTON.

8. Instructions for written test will be forwarded alongwith this admission card.

Signature of Controlling Officer

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