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PERSONAL INFORMATION QUESTIONNAIRE
1.Selection Board (No & Place) Batch No Chest No
UPSC Roll No
2. Name in CAPITALS as in application form
3. Father's Name
4. (a) Place of maximum residence
(b) Present Address (With Approximate
population of the City/town/village)
(c) Permanent Address (With Approximate
population of the City/town/village)
(Whether District HQ or Not)
5.Fill in the details below:
State & District Religion WhetherSC/ST Mother Tongue
Date of Birth
Married/Single/Widowed
6.(a) Parents Alive Yes/No
(b) If not alive your age at the time of Father's/Mother's
Death
(c) Parents/Guardians Occupation /Income (As applicable)
Particulars Education Occupation Income per Month
Father
Mother
Guardian
No of brothers
No of sisters
Your ranking amongst your brother and sister
7. Educational Record(Commencing from matriculation
/Equivalent Examination):-
S.No QualificationAcquired Name of Institute Year Division&Marks%
Medium ofInstruction
Boarder/DayScholar Out Standing Achievement if any
a) Matric/Higher Secondary
b) 10+2
c) B.A/B.Sc/B.Com
d) Professional
8. Age ( Year & Months) / Height (in Metre) Weight
(in Kilograms)
10
(a) N.C.C Training _________________________________________
Yes/No
(b) Total Training (if Yes) (Give details below)
Total Training Wing Division Certificate Obtained
11. a) Participation in Games & Sports
Games/Sports Period or Duration of Participation Represented
School/College/University
OutstandingAchievement, if any
b)Hobbies/Interest
c) Participation in Extra curricular activities :-
Name of the activity group Duration of Participation
Outstanding achievement if any
d) Position of responsibility/Offices held in NCC/Scouting
Sports team/Extra-curricular group and other fields:-
12.
(a) Nature of Commission
(b) Choice of Service
13. Number if chances availed for commission in all
three services
14. Details of last interview ,if any (Air Force/Navy/Army
Selection Board)
S.No Type of Entry Place and SSBNo Date Batch and ChestNo
Recommended/Not
Recommended
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