Coast Guard

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B) Before Clicking on 'Submit', Verify your particulars whether you have filled correctly.

Application : Navik (General Duty)
Personal Details
Candidate Name
First Name *
Middle Name
Last Name
(As given in matriculation certificate)
Father's Name* (As given in matriculation certificate)
Mother's Name* (As given in matriculation certificate)
Email ID* (Please enter the E-mail address you use frequently as this would be used for further communication)
Date of Birth* (dd/MM/yyyy) Make sure, your Date of Birth lies between 01/02/1995 and 31/01/1999
Select your Caste
Marital Status
Your Gender Do you Know Swimming
Proficiency in sports (National Level) Wards of Coast Guard uniform personnel deceased while in service
Is your father serving /retired from Defence Service Type
Permanent Address* State*
District*
City* Pin*
Mobile/Landline No.*  - 



Choice of Centre
Exam Zone*
Choice *
Choice 2*
NCC Qualification, if any
NCC 'C' Certificate
Educational Qualification(For Grading system, convert CGPA into % and then enter % into Aggr. % column.)
ExamPassed IsAppearing Year of Passing Certificate No. Board/University/Institution TotalMarks MarksObtained Aggr %
10 + 2

Marks Entry For Compulsory Subject Of 10+2
EntryTypeIDM04_QualIDM05_SubjectIDCompulsory Subject NameTotal MarksMarks ObtainedPercentage
1 2 1 Physics
1 2 2 Maths

Photograph & Signature Upload (File Type :jpg)
Upload Photograph * (Size for Photograph should be between 10-40 kb) Upload Signature * (Size for Signature should be between 10-30 kb)
   
Employment Details (Optional)
Is Service Personnel Service Type Whether employed in Central/State Govt./Public
sector Undertaking, if so, details thereof
Declaration

I, hereby solemnly declare that all the statements made in the above application are true and correct to the best of my knowledge and belief. I fully understand that in the event of any information being found false or incorrect, appropriate action can be taken against me.

PLACE ::*  SIGNATURE :: 
DATE ::  23Mar2017 NAME OF THE APPLICANT ::
386009   Note : Only Numeric Values
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