FORM OF APPLICATION FOR GRANT OF JCO COMMISSION (Section `A' to be completed by the candidate) 1. Name in Full (in block Capital) : 1. ____________________ 2. Father's Name : 2. _____________________ 3. Army/personal number with rank : 3. _____________________ (for Ex-Servicemen only) 4.(a) Are you a citizen of India, if so, : 4(a) ____________________ whether by birth or descent or registration or naturalisation or otherwise (b) If you are not a citizen of India : 4(b) ____________________ to what place do you claim to belong. 5.(a) Are you married ? : 5(a) __________________ (b) If so, have you more than one : 5(b) _________________ wife living. 6. What is you religion, class or Sub class :6. __________________ (if a member of Scheduled Caste/Scheduled Tribe) 7. Home Address in Full : _____________________ Village/Town : _____________________ House No/House Name : ______________________ Lane/Street/Road : ______________________ Thana : ______________________ PO : ______________________ Telegraph Office : ______________________ Parganah/Tehsil : ______________________ District : ______________________ 8. Details of Punishments : (a) Imprisonment :8(a) ___________________ (b) Red ink Entries : 8(b)_____________________ 9. Do you now belong to the Indian : 9. ______________________ Armed Forces, the Reserve, the TA the Nepalese Army or to any Police Forces? If so give details. 10. Exact Date of Birth/age (in Christain era) : 10. _________________ 11. Particulars of educational qualification : (a) Civil : 11(a) ________________ (b) Military : 11(b) _________________ 12. Particulars of Previous service :- Rank/Capacity Unit/Office Period From To 13. Do you desire your former service in the : 13. _____________________ Indian Armed Force to reckon towards pension, gratuity increments of pay, if such are admissible, and agree to recovery being effected to any gratuity, you may have received on or since discharged in the manner as prescribed in the rules ? 14. Are you willing to be commissioned : 14. _____________________ as a JCO ? 15. Are you willing to be vaccinated or : 5.______________________ re-vaccinated ? 16. (a) Are you willing to go wherever ordered : 16(a) __________________ by land, sea or air and not to allow any caste usage to interfare with your military duty ? (b) You will like to be employed for serving : 16(b) __________________ any where within India if this is permissible under the rules. 17. Are you aware that during your service : 17. __________________ you are not permitted to or to subscribe in aid of any political association or movement ? 18. Are you free from debt ? : 18. ___________________ (Answer `Yes' or `No) 19. Give a list of the documents as proof age, : 19(a) __________________ educational and trade qualification. : 19(b) __________________ : 19(c) ___________________ @ Mention rank, i.e. Sub Ma/Ris Maj, Sub/Ris or Nb Sub/Nb Ris. ----------------------------------------------------------------------------------------------------- Declaration to be signed by the candidate I declare that the statements made in this form are true to be best of my knowledge and belief and I am willing to serve in the Armed Forces for so long as my services are required. Signature of Witness Signature of the applicant Designation Dated : ---------------------------------------------------------------------------------------------------------------- ----- SECTION `B' (To be completed by Recruiting Officer/Medical Officer) Description on Recruitment Height ______________ Cm Chest Measurement :- Weight ______________ Kg Minimum _________ Cm Maximum _________ Cm JC-__________________________________ is considered suitable for employment/ re-employment as a JCO in the ______________ Place : Signature of Commanding Officer Date : ---------------------------------------------------------------------------------------------------------------- SECTION `C' I consider _____________________________________ medically fit in category ____________ /unfit for the *_____________________. Identification Marks 1. 2. * Cause of unfitness ___________________________________________________ Place : Date : Signature of Medical Officer ---------------------------------------------------------------------------------------------------------------- SECTION `D' (To be completed by the Appointing Authority only) Certified that __________________________________________________ is eligible for the grant of a commission as a JCO ____________________ in the ____________________ by virtue of his age, educational qualification and medical fitness. It is further certified that the date of birth/age, educational qualification and medical fitness. It is further certified that the date of birth/age as shown in question No. 10 of Section `A' namely ___________________ has been duly verified from the documents detailed below :- __________________________________________________________________ I recommended/do not recommended him for for the grant of such a commission for the reason given below :- (delete inapplicable portion) Date : Signature : Rank : Designation : Unit : Mention rank for which considered suitable for commission * Mention the Arm of Service i.e. Army/DSC/NCC whichever is applicable. Appendix `B (Refer to Para 7 of SOP 1/2004) BIO DATA Se r No No, Rank and Nam e of JCO Date of Discharge from Previous/prese nt service and Specific cause of Discharge Dat e of Birt h Present/Previo us Arm/Service Servic e as OR and JCO Edn Qualificati on Civil/Army Character Asesed on Discharge from Service/prese nt Medical Categor y (a) (b) (c) (d) (e) (f) (g) (h) (j) Grading in ACR (Last five years Details of Course attended with Grading Does he fulfill al conditions of eligibility Details of Red Ink Entries Recommendation of OIC Records Field Service Instructor Tenure Honours/ Awards (k) (l) (m) (n) (o) (p) (q) (r) Certified that the particulars of JCO given above are correct and he is eligible for re-enrolment into DSC in all respect. Station : (Signature of OIC Records) Dated :
