Annexure-l

Advt N0 ...............................

APPLICATION FORMAT

Recent
Passport size
self attested
photograph to
be pasted
here

(TO BE FILLED IN BOLD ENGLISH CAPITAL LETTERS BY THE CANDIDATE IN HIS

OWN HANDWRITING OR TYPED)
ADVT No : LMRC/HR/243/2016 Date:31.03.2016
I

Name of the post

Name of the Candidate

Fathers/Husband's name
Date of Birth

Permanent Address

Years

Age as on 31.03.2016

Address for correspondence

Contact

Category (SC/ST/OBC/Genl)

No. with Fax & Email

Months

Days

Details of educational

10th

qualification from matriculation

12th (Inter)

(Matric)
onwards

Additional
B.Arch/CA/
CWA/CMA/MBA(Fin
ance)/MBA/Master
Qualifications
in HR or
Personnel/Master in
Finance with
marketing

a)Examination passed
b)Year of Passing
c)Name of the
Institute/University/Board
d)Subjects
e )Marks Percentage in aggregate
f)Division/Grade
Details of experience along with

10

pay scale/pay package

(In chronological order)

11
Details of current service
a) Date of Appointment
b) Post & Grade at the time of
appointment
c) Total length of service
d) Present Post & Grade
e) Date from which in present
post held

Note: Self attested copies of documents in support of information given at 9, 10 & 11 above
should be enclosed with the application.
I hereby declare that the particulars furnished above are true. I understand that my candidature
will be cancelled if the information found to be false or incorrect.
Date:
Place:
Signature of the candidate
Phone No ................................
Email id .....................................