STUDENT POLICE CADET PROJECT

KERALA

Fkv. ]n. kn ]²Xnbnte-bv¡v tIUäpIsf XncsªSp¡p¶Xn\pÅ At]£

Application Form for the Selection of SPC Cadet
1 hnZymÀ°nbpsS t]cv / Name of Student

aebmf¯nÂ
In English (in Block Letter)

2 P\\ XobXn/ Date of Birth

3 enwKw / Sex

4 kvIqÄ/ School
5
¢mÊv, Unhnj³ /
Class, Division

6 bp.sF.Un \¼À/ UID No.

7 cà{Kq¸v / Blood Group

8
ANvOsâ t]cv / Name of
Father

9
ANvOsâ sXmgnÂ/ Father’s
Occupation

10
ANvOsâ t^m¬ \¼À/
Father’s Phone Number

11
A½bpsS t]cv / Name of
Mother

12
A½bpsS sXmgn / Mother’s
Occupation

13
A½bpsS t^m¬ \¼À/
Mother’s Phone Number

14
c£IÀ¯mhnsâ t]cv /
Name of Guardian
c£IÀ¯mhnsâ t^m¬
15
\¼À/ Guardian’s Phone No.

16
ktlmZc§fpsS hnhcw/
Details of Siblings.

ØçÙÞÆøB{ßW ¦æøCßÜᢠSPC ÉiÄßÏßW ¥¢·ÎÞÏßGáçIÞ? ©æICßW ÕßÕøBZ

17
ºáÕæ¿ çºVAáµ. Any siblings enrolled in SPC Project before? If so give details
t]cv / Name ÕßÍÞ·¢ / Wing kvIqÄ/ School hÀjw / Year
18 ta hnemkw/ Address
ho«v t]cv þ \¼À/
House Name – Number

kvYew/ Place

Pnà / District

]n³tImUv/ Pin Code

]mTy þ ]mtTyXc anIhpIÄ /
19 Curricular - Extra Curricular
Achievements **

20 aXw þ PmXn/ Religion - Caste

21 hnZymÀ°nbpsS H¸v

k½X]{Xw
Fsâ aI³/ aIÄ/ B{inX³ Bb ........................ ¢mkn ]Tn¡p¶
.................................................................... F¶ hnZymÀ°nsb Fkv.]n.kn
]²Xnbn tNÀ¡p¶Xn\pw, aäp PnÃIfn DÄs¸sSbpÅ {]hÀ¯\§fnÂ
]¦mfnbm¡p¶Xn\pw F\nbv¡v k½XamWv.

XobXn c£IÀ¯mhnsâ H¸v

c£IÀ¯mhnsâ t]cv

** ]mTy þ ]mtTyXc anIhpIÄ v (]camh[n 10 amÀ¡v) (km£ys¸Sp¯nb kÀ«n^n¡äv ]IÀ¸v lmPcm¡pI)

Iem ImbnI, im{kvX, KWnX im{kvX, {]hÀ¯n ]cnNb tafIfnÂPnÃm kwkvYm\ Xe§fn F tKUv
amÀ¡v t\Snb Ip«nIÄ¡v (]camh[n 5 amÀ¡v)
Ifcn¸bän AwKoIrX kÀ«n^n¡äv/ aäp amÀjy BÀSvkpIfn »m¡v s_Âäv F¶nh t\SnbhÀ¡v
(]camh[n 5 amÀ¡v)
\o´Â ]cnioe\w ]qÀ¯nbm¡n Sports Council sâ kÀ«n^n¡äv t\SnbhÀ¡v 3 amÀ¡v
tZiobXe¯n hnhn[ taJeIfn anIhp sXfnbn¨ Ip«nIÄ¡v 10 amÀ¡v