1. The document contains a registration form for Punit Kumar, an Indian national born on May 9, 1999 who is applying for Group XY and has intermediate/12th standard qualifications with 80% aggregate marks. 2. His communication and permanent address is the same - Village Kazipur, Ghoshipur, Meerut, Uttar Pradesh with a mobile number of 8266973998. 3. He has applied for Group XY as his first preference and identifies a cut mark on his left hand as his identification mark.

1. Office Use Office Use Office Use Registration No
15034152795
1.Candidate Name PUNIT KUMAR 2.Parent Name BABURAM 3.Nationality Indian
4.Date Of Birth 05-09-1999 5.Marital Status Un Married 6.Qualification Intermediate
EPCB
7.Intermediate/Voca
tional/Diploma
English %
405 8.Name of
Intermediate/vocatio
nal/Diploma
UP Board of
Higher School &
Intermediate
Education
9.Matric Board UP Board of
Higher School &
Intermediate
Education
10.Matric Roll No 0607497 11.Aggregate 80 12.Mobile No 8266973998
13.EMail Id swastikgroup10@g
mail.com
14.SOAFP No 15.Discharged from
Forces
No
16.Stream Applied Group-XY 17.Identification
mark
A CUTT MARK
ON LEFT HAND
18.Candidate Height 168cm
19.Exam Center
Choice 1
3 ASC Kanpur 20.Exam Center
Choice 2
2 ASC New Delhi 21.Exam Center
Choice 3
1 ASC Ambala
22.Permanent
Address
VILLAGE
KAZIPUR
,KAZIPUR,GHOS
IPUR
,MEERUT,Uttar
Pradesh,250002,
23.Communication
Address
VILLAGE
KAZIPUR
,KAZIPUR,GHOS
IPUR
,MEERUT,Uttar
Pradesh,250002,
24.Preference for
group XY candidate
only
1st preference: X
2nd preference: Y
DECLARATION BY THE CANDIDATE
I hereby declare that all statements made in this application are correct.I understand that I am
liable to be disqualified at any stage, if the information given is found to be
incorrect/incomplete/false. I undertake to produce all original certificates and statement of marks
and three photocopies of each, duly attested by a Gazetted Officer, at the time of appearing in the
Selection test. I am willing to undergo physical and medical test, at my own risk and will not be
entitled for compensation for injuries if any, sustained during such test. I am aware that the
decision by President, CASB will be final and binding on me.
Shirt Size: cm Shoe Size(BATA): Waist Size: Inch
Signature of the candidate
Signature of parent/guardian
(If candiddate below 18 yrs on the day of filling application)
Name(Gaurdian if applicable ) :
Place:
Date:
Paste your
photograph
Left Hand Thumb
impression
-------------------------
1 50341 52795 4
-----------------------Tear off and Paste on Envelope------------------- -----------------------Tear off and Paste on Envelope-------------------

2. To,
President
Central Airmen Selection Board
PO Box: 11807
New Delhi-110010 1 50341 52795 4
15034152795
Group-XY
80