APPLICATION FOR THE POSITION OF : _______________________ (CONTRACTUAL) POSITION CODE :_______________

1. Name in full (in Block Letters) :
   
   
2. Fathers/Husbands Name :
   
   

Attested

1. Address for communication :
   
   
2. Photo (with Pin Code, Telephone number & E-mail ID) :
1. Permanent Address :
   
   
1. (a) Date of birth (in Christian era) : (copy of DOB certificate to be enclosed) :
   
   
2. (b) Age as on closing date of application
2. Nationality :
   
   
3. Whether worked in any Central/State/UT/ Autonomous body/PSU/Port Organization/Semi-Govt. with proof :
   
   
4. Educational/ Professional Qualification: (Starting from Matriculation or Equivalent onwards)
   
   
5. Experience : (Including present employment)
   
   

Sr. No.	Examination Passed	Year	Name of Board / University	Class/Division	% of marks	Main subjects

Sr. No.	Name of Employer	Designation of the post held & nature of appointment	Pay scale/Salary (CDA/IDA)	Date of Joining	Date of leaving and reasons for leaving	Nature of duties performed

[

1. Languages known :
   
   
2. Any other information such as experience, training, publication etc. in support of suitability for the post :
   
   
3. Preference of place of posting :
   
   

UNDERTAKING

13. I hereby solemnly declare that the information given above is true and correct to the best of my knowledge age belief. Place: Date: SIGNATURE OF THE APPLICANT