Government of Pakistan

Ministry of Interior
Directorate General Civil Defence

(Name of Institution)

PART-I Photograph

APPLICATION PROFORMA FOR PRIVATE PARTICIPANTS

Applicant must apply for admission in the course (along with all attested copies of relevant
documents) at least 15 days before the commencement of course.

I, ___________________________________ S/O ______________________________

Intend to undergo training course namely ___________________________________________

at Federal Civil Defence Training School, __________ as a private candidate. My candidature is as under:-

1. CNIC No.______________________________
2. Date of Birth:_______________ 3. Religion: _____________ 4. Nationality: ___________________
5. Marital Status: _____________ 6. Domicile (Province & District): ___________________________
7. Highest Academic Qualification: ______________________________________________________
8. Technical Qualification: ____________________________________________________________
9. Experience: ______________________________________________________________________
10. Postal Address: __________________________________________________________________
________________________________________________________________________________
11. Permanent Address: _______________________________________________________________
________________________________________________________________________________
12. Cell Number: ___________________ 13. Telephone (Office): ___________________
14. Telephone (Residence): _______________ 15. email (if any): _____________________________
16. Name, Address and Contact of the person to be approach in case of emergency:-
________________________________________________________________________________
________________________________________________________________________________
In light of the above mentioned facts, I request for admission to the aforesaid course.

17. Signature of applicant:- ________________

Page 1 of 2
 PART-II
18. Recommendation/Remarks of concerned District Civil Defence Office:-
_________________________________________________________________________
_________________________________________________________________________

Signature and Stamp

19. Two References (reference) must be a Gazette Officer:-
Reference No.1 Reference No.2
Name:____________________________ Name:___________________________
Designation:_______________________ Designation:______________________

Signature: ________________________ Signature: ________________________

Stamp: _________________________ Stamp: _________________________

Telephone (Office):_______________ Telephone (Office):_______________

******************************************************************************************************************
PART-III
UNDERTAKING

20. I solemnly affirms that the above mentioned information is correct to the best of my knowledge and
belief. I shall abide by all rules, regulations and discipline of the institution applicable on me. In case of any
violation on my part, the institution shall have the right to struck me off the course besides recovery of any
pecuniary loss caused to any government property owing to any negligence on may part.

Signature of applicant:- ________________

******************************************************************************************************************
PART-IV
FOR OFFICIAL USE ONLY
The paper scrutinized and found as per requirement besides at random verification has also been
done. Submitted for approval please.

Training Assistant
Instructor
Ma be / may not be approved.

Commandant / Director