APPLICATION FORMAT

(Only female candidates of Indian nationality)B. Sc. Nursing/General Nursing & Midwifery (GNM) Course 2015(Not to be sold)

Note: Do not put dash (—) in any column or leave it blank.

1. (a) Name of Applicant (Give one box gap between First/ Maiden/Surname) (as per matriculation certificate):

(b) Name of Applicant in Hindi : ___________

2. Date of birth (in Christian Era): ____________ Age as on 01 Aug 2015 : _____ yrs_______months ____ days (Attach matric certificate for proof))

3. Marital status : Unmarried/married/divorcee/widow without encumbrances

4. Name of Father/Guardian : _______________________

5. Complete Postal Address : _______________________ For communication (PIN code mandatory)

6. Permanent Home Address : _______________________________

7. Tele No/Mobile No. (With STD code): ________________________ E-mail ID : ___________________________________

8. Nationality : Indian__________________ Any other_______________

9. Caste: General/Schedule Caste/Schedule Tribe__________________ (Attach proof in case of SC/ST issued by SDM/ Tehsildar)

10. Sr Secondary (10+2)/equiv exam & Percentage of Marks :Passed ( ___%) / Appearing (Open school students not permitted . Certificate to be attached from Principal mentioning subjects PCB as elective subjects in std XI)

11. (a) How many times have you appeared/attempted for BSc/GNM in Armed Forces? _________________ ___________________ (b) Selected/Not selected __________________________ (c) If selected, furnish details of not joining/termination of training: ___________________________________________________

12. Have you been trained in B Sc (N)/GNM (attach proof and mention details of course completed)? _____________ _____________ ___________

13. Choice of Written Test Centre (Three choices are essential): (i) ___________ (ii) __________ (iii) __________________

14. State the choice of institution in order of preference for admission (applicable if finally selected for training). Allotment will be made on merit cum choice basis subject to the vacancies at each institution. (It is Mandatory to mention all the 07 choices)

(i) If no preference is stated against a particular institution, you will be considered for only those institutions for which you have given preference and will not be considered for any other institution even if seats are available. (ii) If same Institution’s name is mentioned in order of preference repeatedly, you will be considered for one institution only, and will not be considered for any other institution even if vacancy exists.

(iii) Subsequent to passing the final year University examination for B Sc (Nursing) course and DGAFMS Examination for General Nursing and Midwifery course all candidates will be offered a commission in the Military Nursing Service. The date of declaration of result from respective Universities will be the date of commissioning for the candidates passing out of Colleges of Nursing and the date of completion of course will be the date of commission for candidates passing out from Schools of Nursing. The date of commission determines the date of seniority in service among all candidates who have joined the course in the same year. The tentative month of declaration of result of the existing 05 Colleges by the Universities and 02 Schools of Nursing is as given in the table below:-

S NO Name of Institution

No. of seats availaible

Choice of centre in order of preference (1-7)

Tentative date of Declaration of results

1. *CON, AFMC Pune 40 Jul/Aug

2. CON,CH(EC) Kolkata

30 Sep/Oct

3. CON, INHS Asvini 30 Jul/Aug

4. CON, AH (R&R) ,NEW DELHI

30 Jul/Aug

5. CON,CH (CC), Lucknow

40 Sep/Oct

6. **SON,CH (AF)BANGLORE

20 Mar

7. **SON,CH(WC),Chandimandir

20 Mar

*CON-College of Nursing, **SON-School of Nursing ** Case being processed to upgrade Schools to Colleges of Nursing I hereby certify that the above information is true to the best of my knowledge and if the authorities find anything false, my candidature is liable to be cancelled at any stage of my training period.

Place : ______________ ________________ Date : ______________ Signature of Applicant

INFORMATION ALSO AVAILABLE ON WEBSITE : www.indianarmy.nic.in/www.indianarmy.gov.in (To be enclosed with application in TRIPLICATE on A4 size paper)

BSc NURSING/GENERAL NURSING & MIDWIFERY (GNM)COURSE : 2015

ADMIT CARD: WRITTEN TEST / INTERVIEW 1. Name ________________

2. Visible Identification Marks : _________________ (Mandatory)

3. Roll No : _________________

4 Date of written test : ____________

5. Time of written test : 0930 hrs

6. Test Centre : ____________________

_____________________ ______________________

7. Date of interview : ____________________

8. Time of interview : 0830 hrs

9. Interview Centre : ____________________

_____________________

Note : Only column 1 & 2 will be filled by the candidate in capital letters. Please carry this letter and a black ball point pen only for use on OMR answer sheet along with you for the written test. Each application must be accompanied with 3 sets of admit cards on separate sheets of A4 size.

Signature of the issuing authority IHQ of MoD (Army)