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CONFIDENTIAL 
PERSONAL INFORMATION QUESTIONNAIRE 
 
1. 
 
Selection Board (No. & Place 
 
Batch No. 
 
Chest No. 
 
UPSC/Other Roll No. 
  
 
   
 
2.  
Name in capital (As in the application form)     _______________________________________ 
3. / Father Name      _______________________________________ 
4.  
(a) Place of Maximum Residence (Place, District, State)   _______________________________________ 
 
(b) Place of Present Residence (Place, District, State)    _______________________________________ 
 
(c) Place of Permanent Residence (Place, District, State)   _______________________________________ 
/ (Whether District HQ or not)   _______________________________________ 
5. / Fill in the details below :- 
 
State & District 
 
Religion 
 
whether SC/ST 
 
Mother Tongue 
 
Date of Birth Married/Single/Widower 
 
 
 
     
6. (a) Parents alive      /Yes/No. 
 
       If not alive, your age at the time of father/mother’s death   _______________________________________ 
 / Parents/Guardian Occupation/Income (as applicable)  
 / Particulars   / Education  / Occupation   / Income per Month  
 / Father  
   
  / Mother  
   
  / Guardian  
   
   / Elder Brother/Sister 
   
  / Elder Brother/Sister 
   
  / Younger Brother/Sister 
   
  / Younger Brother/Sister 
   
 
7. Educational Record (commencing from Matriculation/Equivalent Examination):- 
 
/Qualification 
acquired 
/ Name of 
Institution 
 
Board/ 
University 
 
/Year 
/Division & 
Marks% 
 
/Medium of 
Instruction 
 / 
Boarder/Day 
Scholar 
 / Outstanding 
achievement if any 
 
Metric /Hr. Sec. 
       
 
10+2 equivalent 
       
 
/Graduation 
       
 
/Post Graduation / 
Professional 
 
 
      
/ O.I.R. _____ 
Page 2


 
 
CONFIDENTIAL 
PERSONAL INFORMATION QUESTIONNAIRE 
 
1. 
 
Selection Board (No. & Place 
 
Batch No. 
 
Chest No. 
 
UPSC/Other Roll No. 
  
 
   
 
2.  
Name in capital (As in the application form)     _______________________________________ 
3. / Father Name      _______________________________________ 
4.  
(a) Place of Maximum Residence (Place, District, State)   _______________________________________ 
 
(b) Place of Present Residence (Place, District, State)    _______________________________________ 
 
(c) Place of Permanent Residence (Place, District, State)   _______________________________________ 
/ (Whether District HQ or not)   _______________________________________ 
5. / Fill in the details below :- 
 
State & District 
 
Religion 
 
whether SC/ST 
 
Mother Tongue 
 
Date of Birth Married/Single/Widower 
 
 
 
     
6. (a) Parents alive      /Yes/No. 
 
       If not alive, your age at the time of father/mother’s death   _______________________________________ 
 / Parents/Guardian Occupation/Income (as applicable)  
 / Particulars   / Education  / Occupation   / Income per Month  
 / Father  
   
  / Mother  
   
  / Guardian  
   
   / Elder Brother/Sister 
   
  / Elder Brother/Sister 
   
  / Younger Brother/Sister 
   
  / Younger Brother/Sister 
   
 
7. Educational Record (commencing from Matriculation/Equivalent Examination):- 
 
/Qualification 
acquired 
/ Name of 
Institution 
 
Board/ 
University 
 
/Year 
/Division & 
Marks% 
 
/Medium of 
Instruction 
 / 
Boarder/Day 
Scholar 
 / Outstanding 
achievement if any 
 
Metric /Hr. Sec. 
       
 
10+2 equivalent 
       
 
/Graduation 
       
 
/Post Graduation / 
Professional 
 
 
      
/ O.I.R. _____ 
 
 
 
8. / Age (Year & Months)   / Height (In Metre)   / Weight (In Kilogram)   
______________________________  __________________________ ______________________________ 
 
Present Occupation and Personal monthly income. If any ____________________________________________________________ 
9. (a)  / N.C.C. Training       / Yes /No   
(b)  / If Yes, Total Training (Give details below) 
” / Total Training   / Wing   / Division   / Certificate Obtained  
 
 
   
 
   
10. (a)  / Participation in Games & Sports :- 
  
Game / Sports  
 /Period of 
duration of Participation  
 Represented School/ College/ 
University 
 
Outstanding achievement if 
any  
 
 
 
   
 
 
11. (b)  / Hobbies / Interest 
(c)  / Participation in extra-curricular, activities :- 
 
Name of the activity group 
 
/ Duration of Participation 
 
Outstanding achievement if any 
 
 
 
  
 
(d)  
Position of responsibility/ offices held in NCC / Scouting / _____________________________________________________ 
Sport team / Extra-curricular Group and other fields   _____________________________________________________ 
12. (a) ” / Nature of Commission 
(b)  / Choice of Service 
13. ”       
Number of chances availed for commission in all three Services _____________________________________________________ 
14.    
Details of previous interviews, if any (Army/ Navy/ Air Force Selection Boards) 
 
St. No.   
 
Type of Entry  
  
SSB No. and Place  
 / Date  
   
Chest No/ Batch 
No. 
 Recommended/ Not 
Recommended  
 
 
 
 
 
 
 
 
 
 
     
 
 
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