Comprehensive Heath Insurance Agency Kerala

7th Floor TransTower, Vazhuthacaud

Thiruvananthapuram – 14

APPLICATION FOR THE POST OF ASSISTANT MANAGER (OFFICE ADMINISTRATION)

1. Name :

2. Age & Date of Birth :

3. Permanent Address with Dist. :

4. Present Address :

5. i. Name of Father :

ii. Occupation of Father :

iii. Name of the Mother :

iv. Occupation of Mother :

6. Qualifications
School/ Aggregated
Sl.
Qualification Institution Period percentage
No
Studied of marks
1 SSLC
2 Plus Two
3 Degree
4 MCA
5 MBA
6 Any other (Specify)

7. Experience
Sl. Organization for which
Nature of Work Period
No worked
1
2
3
4
 8. Computer Experience
Sl.
Software Period of Experience
No
1 Database Management
(SQL server/MS Access/Oracle)
2 Specify
3 Specify
4 Specify
5 Specify

9. About the applicant

(Brief note about the applicant not exceeding 300 words)

10. About Kerala

(Brief note about Kerala State not exceeding 300 words)

AFFIDAVIT

I hereby declare that all the information given above are true to the best of my
knowledge and all my claims will be proved with original testimonials, if and when called
for the interview.

Place: Signature:

Date: Name:

Please note
1. Application may be sent by E-mail to jobs.chiak@gmail.com marking a copy to edir@chiak.org on or
before 27th November 2010.
2. Application copy along with self attested copies of certificates may be sent to Executive Director,
Chiak, 7th Floor Trans Tower, Vazhuthacaud, Thiruvananthapuram – 14. Application should reach the
Office of Chiak on or before 30th November 2010. The E-mail Applications will not be considered, if
application in hard copy is not submitted in time.