Application Form - Indira Gandhi Rashtriya Uran Akademi

Instructions for Offline Mode of Applications :
1. Downloaded form alongwith DD or proof of payment duly filled should be sent by Speed Post to reach
th
IGRUA latest by 10 May 2015.
2. List of Examination Centres tobe filled in the Application Form may be downloaded from the link :http://www.igrua.gov.in/Entrance/Examination%20Centres.pdf
3. Acceptance of Candidature will be acknowledged telephonically/ email alongwith the allotted Centre of
Examination.
4. Valid Identity proof to be produced at the centre of examination.
5. Completed Applications should be sent to:
Chief Ground Instructor,
Ground Training Department
Indira Gandhi Rashtriya Uran Akademi
Fursatganj Airfield
Amethi (U.P.) PIN 229302.
6. For any query for offline mode of applications, please contact :Ground Training Department
Email : gtd@igrua.gov.in
Tel : IGRUA 0535 – 2441147 Ext (117,102)
Fax: 0535-2441527
APPLICATION FORM - Entrance 2015
Paste
Recent
3 cm x 4 cm
Passport size
Photograph and
Sign
Ab-initio to CPL Course
LAST DATE FOR RECEIPT OF APPLICATION
07th May 2015
( Please Tick √ one as per option )
1. Examination Centres :
1st Option :
2nd Option :
3rd Option :
4th Option :
2. Candidate’s Name :
(F
I
R
S
T
N
A
3. Sex : M / F Tick √ as applicable
M E)
(M
I
D
D
L
E
N
A
M E)
(L A
S
T
N
A
M E)
4. Email id :
5. Father’s Name :
6. Postal Address :
City
State
STD Code
PIN
Landline
Mobile
( Tick √ as applicable and produce relevant certificates before Interview )
* OBC candidates who fall under Non-Creamy Layer as per GOI guidelines should Tick √ in OBC Check Box for applicable relaxation.
7. Category :
GEN
/ SC / ST / OBC
D
D
/
8. Date of Birth :
/
/
M
M
Note: Candidates must be 17 years before joining the course
/
Y
Y
9. Qualifying Examination ( 10+2 or equivalent ) :
(i) Board of Qualifying Examination
CBSE
/
CISCE
/ Any Indian State Education Board / Any Other Equivalent Board / University
Result
Awaited ? Yes / No
% Marks
Obtained
%
Result
Awaited ? Yes
/ No
% Marks
Obtained
Year of
%
Completion
Result
(iv) 10+ 2 Physics
Awaited ? Yes / No
% Marks
Obtained
Year of
%
Completion
(ii) 10+ 2 English
(iii) 10+ 2 Maths
Year of
Completion
Not Eligible for course if,
i. Not Passed English in 10+2
OR
ii. Aggregate % Marks in 10+2
i.e.
( % 10+2 Maths + % 10+2 Physics ) / 2
Less Than
 55% for Gen Candidates.
OR
 50% for SC / ST / OBC candidates.
Note: Candidates awaiting final result will be allowed to undergo admission process provisionally subject to fulfilling their Eligibility
requirements and production of documents in original at the time of interview.
10. Demand Draft Details :
( Only SC / ST Candidates are exempted from Application fee )
In favor of
Payable at Amount Demand Draft / UTR No.
Indira Gandhi Rashtriya
Raebareli Rs. 6000/Uran Akademi
Dated
/
Drawn on Bank
/15
11. Declaration : I hereby declare that the particulars furnished above are true to the best of my knowledge and if above
information is found to be false or incorrect at any stage, I understand that my candidature will stand cancelled.
12. Enclosures : a) Demand Draft
b) Two Self Attested Passport Size Photographs
(One pasted on Application Form and the other enclosed with Name overleaf)
Date :
/
/ 2015
( SIGNATURE OF CANDIDATE )