CONFIDENTIAL

PROFORMA FOR SECURITY CLEARANCE

PIEAS / KINPOE
1. Name Gender
2. Fathers Name
3. Date & Place of Birth
4. Nationality Religion ect !aste
". !N#! No $%ttach Photoco&y'
(. Present %ddress & )ele No.
*. Permanent %ddress

+. Names of t,o references ,ho can testify the candidates character-antecedents./
Name Address Contact Number
0. 1dn-23alification-14&ertise
15. ession $D3ration of t3dies'
11. 6ast #nstit3tion attended
12. D3al Nationality $if held'
13. 7o8ile Phone No. and 1mail
14. Foreign co3ntries 9isited d3ring last " years
Name of Country Purpose
Place. ignat3re.
Date. Name.
Roll No. %llotted 8y P#1%.

Countersigned

CONFIDENTIAL
Photograph
CONFIDENTIAL
SCEF-0001
PROFORMA
INTERNSHIP / FELLOWSHIP
STRATEGIC COMMISSIONS
1. Name $s' of #nternee.
2. on - Da3ghter of .
3.
!N#! No.
4. Desired sched3le of #nternshi&. From )o
a. D3ration. 2514 251(
8. Recommending :ni9ersity . P#1% ;#N<P1
". =en3e to 8e 9isited. P#1% - ;#NP<1
(. !ategory. ---------------
*.
ec3rity tat3s > !leared 8y #)
$#n case ?es@ attach &hotoco&ies'
+. Bio data of #nternee attached.
0. %ny other significant information.
CONFIDENTIAL
?es
No
?es
No
- -