APPLICATION FOR THE POST OF OFFICER (SCALE I)

Post applied for :

Name of the Candidate :

Affix your recent
Passport size
S/o / D/o :
Photograph and
sign across

Address :

State: Pin Date of Birth

DD/MM/YYYY
Telephone No. Age:
(with STD Code)

Mobile No.: Sex (Mark X) Male Female

E-mail ID: Category (Mark X) Gen SC ST

Qualification Main Subjects Name of the University Year of Passing % of Marks

Other Qualification (if any)

Work Experience

(Documents pertaining to Academic Qualification and work experience, if any are mandatory along with Bio-Data/CV)
Enclosures (Please Tick as applicable)
Bio-Data/CV
Photo copies of all Mark Sheets & Provisional/Convocation certificates of Graduation/Post-Graduation
Work Experience certificate from the Employer
Photo copy of Caste Certificate for SC/ST candidates

I hereby declare that all the particulars given above 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 or misrepresented at any stage or
not satisfying the eligibility criteria according to the requirements of the relative adver tisement, my
candidature/appointment is liable to be cancelled/terminated.

Date :
Place : (Signature of the Applicant)