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B.Sc (Environmenlal
Science)
M.Sc (Environmental
Scienc€)
M.SC (Eiodiversity)
B.SC (Geology)
B.SC (Botany)
M.SC (Geo.
lnformation)
3q qrF& E aifffr 6Ta6r-r B.E. Computer, t9
a-r_drd Elrr.t BE Elec,lronics,
Electronics &
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Management/MSw/
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(+rdrilfrd E !1T€T6t) (Registration Date)
(Registration No. Office Use)
1 €.lEt aiE
(Full Name)
3Ir$r.I (Surname) rf{dr{r-A arq (Name) sGEri/qfii ard
(Father/Husband Name)

2 a;q Eai6' 3.fu4 (Ffi/q5c)

(Date of Birth) Gender (Male/Female)
I tr* lRetigion) 5.ard (Cast)

6 $rtrr Ffri6 : 7.arfiEr e-flt .' (cast

(Aadhar No.) Category)
(sc/sr/oBc/sBCA/J(A) /Nr(B) /
Nr(c) /Nr(D)/oPEN)
8 SfndRrqr cadr'
(Address)

6165r (T3luka):- B6r lDistrictl:--------------------ffir5 (Pincode):-------

g mmsqfr e;qitr : 1o.f-fil 3iEEI

(Mobile No.) (E-mail id)
11 #t-Er awha (Bank Detait)
11.1 fi;i arE :

(Name Of Bank)
11.2 Qn€[: Ert a;Fi6':
(Branch) (Account No.)
1 1.3 3nq.(rs.(rq.fr (lFS Code )

12 rqar tqfiffi, qriral (High€r Quallflcatlon)

12.1 y.dET a;ffi at (vear) rlT?-qrr (Medium) 6$ffi (Percentage)

rfren lPass
Exam)
1
13 dr€aalil firffirtff : (ilq s qFi) ------- d{ ------- {BA
(Period of residence in Maharashtra (Year & Months) -----Year----Months

1s 3{Flur NAps/MAps qr ffiqr

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(Have you availed the benefit of NAPS/MAPS or scheme?) Yes/No

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(Are you currently unemployment?) Yes/No

1E 3tFIUi {rLqr RtaT"r d-d 3{r6kr 6r ? dtqEr&

(Are you currently studying?) Yes/No

1te rffit ffi 3rdr qtd-d ffi arrrq trl: (Documents required to be attached with candidate
registration application:)
1 qtHrFffi' qri-dr yqruFrl (Educational certificates)
Z. :rffi Ersar /10 A qr€ rrnErq-fl .,t,rrEr€r6rr qr +6I (16, srrurqr
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3. q6 A;&f,r affir (Cance ed Cheque)
4. 3rrqE 6rg (Aadhar Card)

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(Candidale Signature)
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 CMYKPY Candidate Registration and Joining Form
This form is for CMYKPY Candidate Registration
(Please fill all details carefully)

'1. Employer Email id -

2 Offline Regiskation Date
(Please mention the date when you filled the offline registration form)

3. Full Name
4. Father/Husband Name
5. Mother's Name
6. Date of Birth
(Age at the tirne of application should be between 18 years to 35 years).
7. Gender
8. Ivlobile No
9. E-mail id of Applicant
10.Aadhar No
1 1. Religion
12. Caste
't 3. Caste Category
14. District

1 5. Taluka
16. Address
17. Pin code
I 8. Hithest Qualmcat'ron

(Mention highest qualifi cation of the candidate)

1 9. Passing Year
(Please enter year you completed your highest qualification)

20. Medium
21 . (Please mention your medium of education)

22. Percentage/C6PA
(Please mention Percentage of Highest Qualification)

23. Have you completed any skill development course, if yes please specify
24.Period of residence in Maharashtra (in Years)
( For domicile, candidate must be resident of Maharashtra for minimum 15 years )
25. Have you availed the benefit of NAPS/MAPS scheme

26.Are you currently unemployed

27 . Are you currently studying

(BANK DEIAITS OF CANDIDATES)

28. NAME OF BANK

29. BRANCH NAME

30. ACCOUNT NUMBER

31 . ifs code

32, DATE OF JOINING

(EMPLOYER DETAILS)

33. NAME OF EMPLOYER WHERE THE APPI.ICANT JOINED

34. EMPLOYER MAHASWYAM REGISTRATION NUMBER

35. iorN|NG LocAnoN

36. AODRESS OF EMPTOYER

37. PINCODE OF EMPTOYER

38. MOBITE NUMBER OF EMPLOYER

39. NUMBER OF EMPLOYER

40. ORAGNISATION PAN / TAN / EPF / ESIC WHICHEVER IS APPLICABLE

Al FOR -
GOVT

1. PAN NO 2. TAN NO

B) FOR PRIVATE

1. EPF 2. GsT 3. ES|C

C) FOR START UP

I. DPIT