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Page 1
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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Document Description: Sample PIQ Form for CDS 2024 is part of Preparation Tips for SSB Interview preparation.
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Additional Information about Sample PIQ Form for CDS Preparation
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The content of Sample PIQ Form is prepared as per the latest CDS syllabus.
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