APPLICATION PERFORMA

Application for Engagement of Various Posts on Contract Basis

*To be filled up / typewritten in CAPITAL LETTERS

Date: - DD-MM-YYYY _________________

1. Name of the Post: ____________________________________

2. Name of the Candidate: Mr. / Ms. ________________________

3. Fathers Name: Mr. _____________________________

a. Mothers Name: Ms._____________________________

b. Husbands Name: Mr.____________________________

4. Gender: Male / Female ___________________

5. Date of Birth (*): DD-MM-YYYY _______________________

6. Age as on 15-Nov-2017: ______ (Years) _______ (Months) ________ (Days)

7. Nationality: _______________________

8. Address for Correspondence (*): - ______________________________________________________

___________________________________________________________________Pin Code__________

Contact No. /Mobile No. /E-mail. _________________________________________________________

9. Whether belonging to (*): SC / ST / OBC / PH / Ex-Sev / General _________________________

10. Educational & Professional Qualification from Matriculation and onwards (*):-

Exam Passed	Subject	Univ./Board	Year of Passing	Marks obtained	% of Marks
10th
12th
Graduation
Post Graduation
PG Diploma
Any other

11. Professional Experience (in chronological order) (*):- Total years of exp: ________ Months_______.

Name of the organization	Position held with pay scale or Salary	Period of tenure with dates	Brief description of duties	Detailed experience (date wise)

12. Do you permit to supply a copy of your application form, if demanded under Right to Information Act, 2005(Say Yes or No): ____________________________

13. Other Information, if any: ____________________________

It is solemnly declared that the information furnished above are true. If any of these is found incorrect at any point of time, I shall be liable for action.

Signature of the Applicant

Mobile No. ___________

(*)Attested copies of relevant certificates to be attached.