APPLICATION FORMAT
1. Post Applied for :
2. Advertisement No. & Date : Affix a recent
Passport Size
3. Name of the candidate (In capital) :
Colour
4. Father’s Name : Photograph
5. Spouse Name (if married) :
6. Date of Birth :
7. Age as on 01.09.2024 :
8. Gender :
9. Social Category :
[Link]:
Present Address Permanent address
[Link] No./ Landline No :
12.E-Mail id. :
[Link] Qualification (10th onwards) (Attach copy of Certificates)
Sl. Exam. Passed & Institution Board / Division / % of
No. Year Council / Class Marks
University
[Link] of experience : (Attach in a separate sheet if required)
Sl. Name of Post Held Period Basic Salary
No. Organization
From To
15. Is there any Civil / Criminal /Vigilance case / disciplinary Proceeding pending
/ contemplated against you or you have been penalised for misconduct during the
period up to five years preceding to your retirement: YES/ NO
16. If yes, furnish details:
DECLARATION
I, do hereby declare that the above information is true and correct to the
best of my knowledge and belief. I understood and agreed that any
misrepresentation / suppression of information will render liable for cancelation
of my candidature any stage / termination from engagement forthwith, without
notice.
Date:
Place: Signature in full