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NEW DELHI
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Affix latest
passport
size
photograph
1)
Name of the post Applied
for...................
2)
Name of Candidate:...
3)
Fathers / Husbands Name:
..
4)
Date of Birth:.
5)
6)
Marital Status.
7)
Sex
8)
Permanent Address:....
..
9) Correspondence Address:.
.
Telephone No.. E-mail: ...
10)
.2
-211)
Sl.
No.
1.
2.
3.
4.
5.
Yr. of
Passing
12)
Awards/prizes:
13)
14)
Sl.
No.
Post held
&
Duration
Scale of pay
& basic pay
drawn
Nature of
Duties
1.
2.
3.
4
-315) State briefly why do you consider yourself fit for the post
applied(Use separate sheet and enclose if necessary)
..
...
.
16) a)
Have you ever been arrested/ prosecuted/kept in
detention/bound down/fined/convicted by a court of law or
whether any case pending against you in court of law? Yes/NO
(
if
yes,
please
provide
details)
b)
Have ever been debarred from any fellowship/
examination/ rusticated by any University or any other
educational institution or whether any case is pending against
you in any University or any other educational institution? Yes/No
( if yes please provide details) ..
..4
Date:
Place:
Applicant
Signature
of
NOTE:-Candidates
already
employed
in
Central/State
Government/Autonomous Bodies/PSUs should get the application
forwarded through proper channel and required to produce NOC
at the time of interview, failing which his candidature will not be
considered and no TA will be paid.