SAINIK SCHOOL SAMBALPUR
APPLICATION FORMAT
Affix
1. Post Applied for :____________________________________ Passport size
photograph
2. Name of the Candidate :____________________________________
3. Date of Birth & Age :DOB:______________ Age:_____Years
4. Gender :____________________________________
5. Name of the Father/Husband :____________________________________
6. Marital Status :____________________________________
7. Nationality :____________________________________
8. Caste Category :____________________________________
(Mention – General / SC / ST / OBC)
9. Qualifications (Fill up columns as applicable) starting from 10th or equivalent
S No Qualification Subjects Institution / Board / Year of Division
University Passing and %
(a)
(b)
(c)
(d)
(e)
(f) Any Other Qualifications (including extracurricular activities, sports/NCC etc if any)
______________________
(Signature of the Candidate)
10. Experience (Experience without relevant certificates will not be taken into consideration).
S No Designation Name of the Institution / Brief Experience / Duties Period
Organisation Performed From To
(a)
(b)
(c)
(d)
(e)
11. Languages Known :______________________________________
12. Correspondence Address :______________________________________
______________________________________
______________________________________
13. Permanent Address :______________________________________
______________________________________
______________________________________
14. Mobile Number :______________________________________
15. Email ID :______________________________________
16. Aadhar Number :______________________________________
17. Details of Application Fee :
Name of Bank __________________________
DD No:___________Date:____________Rs.______
______________________
(Signature of the Candidate)
17. Declaration
(a) I hereby declare that all the information furnished above is true to the best of my knowledge.
(b) I hereby submit self-attested copies of certificates (qualifications, experience and caste in case of
OBC/SC/ST).
(c) I am fully aware that if it comes to notice at any time during verification of certificates and during my
service that false information has been furnished or that there has been suppression of actual information in
the application form, my candidature would be liable to the terminated solely on this ground.
_____________________________
Place: __________________ (Signature of the Candidate)
Date: __________________ Name: _______________________