Application Form
Department of Science & Technology, Government of Bihar
Application for Direct Recruitment of Karyalay Parichari
(Advertisement no. 02/2022 )
Application Details
Application ID :
###### Application Date : Post Applied For :
Karyalay Parichari
Personal Details
Applicant Name ALOK KUMAR GOND
Father's Name PRADEEP KUMAR GOND
Mother's Name RAMAWATI DEVI
Marital Status Un-Married
Spouse Name
Ex Serviceman No
Date of Birth 15-Aug-1998
Age as on (01.08.2022) 23 Years 11 Months
Gender Male
State of Domicile Bihar
Home District GOPALGANJ
Category ST
Nationality Indian
Physically Handicapped No
Category of Physically
Handicapped
Percentage of Physically
Handicapped
WARD of Freedom Fighter Yes
Email ID alok.sms01@[Link]
Mobile No. 9852736943
Phone With STD Code
Identification Marks A cut mark on left leg
Address for Correspondence
Address Vill-Bantail post-khajuri PS-kuchaikote dist-gopalganj
Pin Code 841505
Permanent Address
Address Vill-Bantail post-khajuri PS-kuchaikote dist-gopalganj
Pin Code 841505
Educational Qualification
Qualification Board/University Institute/ School/ College Name Certificate Passing Full Marks % of
No Year Marks Obtained Marks
[Link] BSEB PATNA I MEMORIAL HIGH SCHOOL 13 AC 2013 500 321 64.2
SASAMUSA 0973431
Certificate Details
Sl. No. Certificate Name Issuing Authority Certificate No. Issue Date
1 Domicile Certificate CO/RO BRCCO/2021/1399274 12-Mar-2021
2 Caste Certificate SDO BRSDO/2021/124151 12-Mar-2021
3 Disability Certificate
Ward of Freedom Fighter
4
Certificate
5 Experience Certificate
Experience Details
Whether worked as a class IV Employee under the world bank polytechnic education
No
strengthening project in Department of Science & Technology, Government of Bihar,
Patna
Year Experience Claimed 0
Point Details
Educational Point 64.2
Experience Point 0
Total Point 64.2
I hereby declare that I am a citizen of India. The entries in this application form
are complete, true and correct to the best of
my knowledge and belief. I have read
carefully all the rules and provisions related to this advertisement and I promise
to
follow these and also promise that I will not use any unfair means during the
selection process. I fulfill all the eligibility
criteria i.e. Age limit, educational
qualification as prescribed in the advertisement. I have all eligibility certificates,
whenever the Department of Science and Technology, Bihar, Patna will ask for it,
i will produce the same failing which my
candidature can be cancelled by the Department
of Science and Technology, Bihar, Patna at any time. In case of any
information
provided by me is found to be false or incorrect before or after the selection,
the Department of Science and
Technology, Bihar, Patna will have the right to cancel
my candidature and take appropriate legal action against me. I
declare that I have
filled only one application for this advertisement.
Date:-
Signature of Applicant (In English) Signature of Applicant (In Hindi)