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2025021521

The document is an application form for a position at DMHO in Medchal Malakjgiri District, Telangana for the year 2024. It requires personal details, educational qualifications, and supporting documents to be submitted during a walk-in interview. The candidate must declare the accuracy of the information provided and understand the consequences of any discrepancies.

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16 views1 page

2025021521

The document is an application form for a position at DMHO in Medchal Malakjgiri District, Telangana for the year 2024. It requires personal details, educational qualifications, and supporting documents to be submitted during a walk-in interview. The candidate must declare the accuracy of the information provided and understand the consequences of any discrepancies.

Uploaded by

sanaferdous641
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application Form-

DMHO- MEDCHAL MALKAJGIRI DISTRICT, PASTE HERE


TELANGANA - 2024 LATEST
SELF ATTESTED
Name of the Post Applied : PHOTOGRAPH

1. Full Name (BLOCK LETTERS):


2. Father’s/Husband’s Name

3. Date of Birth & Age:

4. Sex: Male/Female
5. Community :
6. Physically Handicapped Category :

7. Contact Particulars: E-mail address:

Mobile Number:

8. (a) Present Residential Address :

(b) Permanent Residential Address:

9 (a) My PAN Card No. is .


(b)My Aadhar Card No. is .
10. Local / Non Local (Specify):

11. Educational Qualifications:


(Please attach attested copies of certificates/degrees in support of your qualifications)
Marks Remarks If
Qualification School College / Year
Any
/College University in
percent
age

12. (a) Present employment/post held :


NOTE:
1. INCOMPLETE APPLICATION WILL NOT BE ENTERTAINED.
2. SUBMIT ALONG WITH APPLICATION, ONE ATTESTED PHOTOCOPIES OF
DOCUMENTS AS PER THE LIST OF ENCLOSURES MENTIONED BELOW AT TIME OF
WALK IN INTERVIEW.

S.No Particulars of enclosures Yes/No


1. SSC Certificate/ Birth Certificate (Proof of Age)
2. Study/ Bonafide certificate (1st to 7th Class)
3. SSC / Intermediate / Degree
4. Recent Passport size colour photo
5. Aadhar Card
6. PAN Card
7. Community Certificate issued by competent authority
8. Physically Handicapped Certificate
DECLARATION BY THE CANDIDATE
(Post applied for )

I hereby declare that the above information is true, complete and correct to the best of my knowledge
and belief. I have not suppressed any material, fact or factual information. I understand that my
candidature is liable to be rejected in the event of any mis-statement/discrepancy in the particulars being
detected and after my appointment in such an event, my services are liable to be terminated without any
notice to me or reasons there of I am not aware of any circumstance which might impair my fitness for
employment.

Date Signature of the candidate


:

Place:

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