APPLICATION FORMAT

Advt. No. Date -

Sl. No applied for

Affix recent self

attested passport size
photograph

Name of the post applied for

01) Full Name (in Capital letter).
02) Fathers Name(in Capital letter)
03) Mothers Name (in Capital letter)
04) Nationality
05) Address for communication..

06) Permanent Address ..

..
07) Date of birth
(Please enclose self attested copy of the certificate.)

08) Age as on 01/01/2014 Years . Months . Days.

09) Category (SC/ST/OBC/Gen)
(the candidates belonging to SC/ST/OBC category must enclose Self attested copy of the certificate as proof)

10) Ground for claiming age relaxation

11)Details of educational ,Professional and technical qualification
Examination
Institution/University Year of passing
Subject studied
Passed

% of marks

12)Marital status ..
13) Religion ..
14) Do you possess a valid HMV license ? (Yes/No)
if, Yes is attached a self attested copy of the same(only for the candidates applying for Sl.
No-03)
DECLARATION: I declare that I fulfill the eligibility condition as per the advertisement and that all the
statements in this application are true, complete and correct to the best of my knowledge and belief. I
understand that in the event of any information being found false or incorrect at any stage or not satisfying
the eligibility conditions according to the recruitments mentioned in the advertisement, my candidature
/appointment is liable to be cancelled/terminated.

Date:
Place:

(Signature of the candidate)

ADMIT CARD
(to be field by office only)

ROLL NO ..

Office Copy

Date of Examination Time

Affix recent self

attested passport
size photograph

Venue

Name of the candidate (in Block letter) ..

Fathers Name (in Block letter) ..

(Candidates signature)

ADMIT CARD
(to be field by office only)

ROLL NO ..

Candidate Copy

Date of Examination Time

Affix recent self

attested passport
size photograph

Venue

Name of the candidate (in Block letter) ..

Fathers Name (in Block letter) ..

Recruitment Authority signature(office use only)

Condition:
1) The candidate must bring this Admit Card along with a Govt. approved photo identity proof(such as Voter Card/Pan
card/Driving license/Passport/etc)
2) Use and carry of book, notebook, calculator, pagers, mobile phone etc is not permitted in the examination.
3) You may please note that this Admit Card does not constitute an offer of employment by the organization.
4) Your admission to the examination is strictly provisional before coming for the written examination please ensure that
you are eligible according to the eligibility criteria stipulated in the advertisement. If you are not eligible, your candidature
will be cancelled at any stage.

Candidates Signature
(to be signed in the presence of invigilators at the time of examination)

Invigilators Signature
(after verification at the time of Examination)