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Print Application

APPLICATION FORM FOR APPOINTMENT OF ASSISTANT PROFESSORS FOR GOVERNMENT FIRST GRADE COLLEGES
(If the applicant desires to apply for more than one post, then the applicant has to apply separately for each post)

Application Details:
Application ID

FG505695

Subject Applying For

History

PG Degree

M.A

Subject studied in PG

History

Educational Qualification

NET, Master Degree

Name of the Applicant (As in SSLC or 10th Std

R VINOD PRAKASH
Marks Card)
If Name different from that in SSLC Marks
No
Card
Date of Birth

16/05/1980

Name of the Mother

LAKSHMAMMA

Name of the Father

RAJAPPA K R

Gender

Male

Are you Married?

No

Examination Centre

Bangalore

Religion

Hindu

Category

GM

Name of the Caste

VOKKALIGA

Are you claiming Age Relaxation?

PH

Are you claiming Reservation Under?

Physically Disabled

If Physically Disabled

Blindness or Low Vision

Are you claiming reservation under

Hyderabad-Karnataka Region - Article 371
(j)?

No

Telephone Details:
Phone(Landline) Number
Mobile/Cell Phone Number

9986699710

Full Postal Address:

Address for Communication

233/9 2ND CROSS NANJAPPA BLOCK KEMPEGOWDA NAGAR BANGALORE

District

BANGALORE URBAN

Pincode

560019

Email ID

vinu.hindh@gmail.com

Marks/Grades obtained in all the years/semesters of Master Degree:

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Particulars of
Qualifying
Examination
Passed

Print Application

Month of
Passing/Notification
of the Degree

Year of
Marking
Aggregate
Passing/Completion Mode CGPA/Percentage

PG

May

2005

NET

October

2009

66.200

Name of
the
University

Place of the
University

KUVEMPU
UNIVERSITY

SHANKARAGHATTA
BHADRAVATHI

BANGALORE BANGALORE
UNIVERSITY UNIVERSITY

Are you presently a permanent employee of? State Government

Have you obtained No Objection Certificate
from Employer for this recruitment
Yes
Note: The NOC shall be obtained on or before
the last date fixed for receipt of application.

DECLARATION
I hereby declare that all statements made in this application are true, correct and complete to the best of my knowledge and belief. I have
read the rules and I understand that in the event of any information being found false or ineligibility being detected before or after the
selection, action can be taken against me by the Government/appointing authority under rule 20 of the Karnataka Civil Services(General
Recruitment) Rules 1977 as amended from time to time.
I have read the Rules and instructions carefully and hereby undertake to abide by them. I further declare that, I will fulfill all the eligibility
conditions regarding age, educational qualifications, reservations etc. where applicable prescribed for the post.

Left Hand Thumb Impression of the Applicant

Signature of the Applicant
DateAdded

Feb 15 2015 11:37:00:000AM

Last Updated
Payment Details:
Challan No.:

184771251

Challan Date:

18/02/2015

Fees Paid:

2000

Payment Status:

Payment is confirmed

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