APPLICATION FORMAT

1.

Candidates Name: -

Attested

(a)

Paste
Passport
Size
Photograph

Name :
(As per Middle with Hindi /Equivalent Certificate)

2.

(b)

Surname or last name:..

(c)

Expanded full name(If abbreviated)

Date of Birth: D D
M M Y
Y Y
Y
(As per Middle with Hindi /Equivalent Certificate)

3.
4.

(a)

Fathers Name: .

(b)

Fathers Occupation/Designation:..

Post for which applied by the candidate:

(In order of preference)
Preference Order
1
2
3
4
5
6
7
8

5.

Name of Post

Address: For correspondence: -...

..
Pin...
Telephone/Fax NO. if any.
E-mail.
Permanent Address: -...
..
Pin...
Telephone/Fax No. if any.
E-mail.

6.

Category:- General/SC/BC-A/BC-B/ESM/Sportsperson..

7.

Marital Status (Married/Unmarried)

8.

State to which you belong

9.

Nationality..

10.

Educational Details: (i)

Educational Qualification

(ii)

Aggregate percentage obtained in Middle %

(iii)

Detail of Marks: -

Examination passed
(Starting From Middle)

11.

Subject
(Main subject including Electives)

Other Qualifications:(i)

Sports..
(Give level of anticipation/achievement i.e.
National/State/University/College/School)

(ii)

NCC.
(Indicate what certificate you are holding)

(iii)

Extra Curricular Activities ..

(Full details of activities)

12.

13.

Details of service under Central/State Govt. if any

(a)

..

(b)

..

(c)

..

(d)

..

Number of IPO/Bank Draft

DECLARATION: (i)

I hereby declare that I am Unmarried/Married Indian Citizen and have

never been debarred from appearing at any examination nor have I ever
been arrested/prosecuted and convicted under any criminal offence by a
court or involved in any other case registered by the police.

(ii)

I, hereby, solemnly declare that all the statements made in the above
application are true and correct to the best of my knowledge and belief.

(iii)

I fully understand that in the event of any information being found false or
incorrect appropriate action can be taken against me.

Place: __________________

Signature_____________

Dated: __________________
Name of Applicant______________