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APPLICATION FORM

For the post of Constable in Himachal Pradesh Police Band in year 2019 Latest Passport
size Photograph
(To be filled in by the candidate)
of the Candidate
To
The Inspector General of Police, (to be stapled
Southern Range, Shimla-171002 only)
Read Instructions below before filling
*Contact/MobileNo.__________________E-mail:____________________________
*1. Full Name of Applicant:

*2. Father’s Name:


*3. (a) Date of Birth (in figures): (DD-MM-YYYY) - -

(in words):

(b) Proof of Date of Birth: Only 10th Class


Certificate will be considered

(c) Name of Board for 10th Class:


Name of School for 10th Class: Year of Issue of certificate
th
(10 class):

Educational Qualification: Name of School:


Name of Board:
Certificate No.: Date of Issue: - -

Additional Educational Qualification:

Year of Passing: Name of Institution

*4. Sex: Male: Female:


*5. Identification mark:

*6. Thumb Impression (TI): Left TI for Male Right TI for Female

*7. Address for Village/H.No.


Correspondence: Post Office
Tehsil:
District:
PIN Code:-

*8. Permanent Village/H.No.


Address: Post Office
Tehsil:
District:
PIN Code:-
*9. Address as per Bonafide Himachali Certificate:
Village/H.No.
Post Office
Tehsil:
District:
PIN Code:-

*10. Issuing authority for Bonafide Himachali Certificate:

*11. (a) Tick (√) Correct Category/Sub Category of post for which applying:
a) b)
Sub Categories:
Category
IRDP/Antodaya

General Ward of Freedom Fighter

SC Home Guards

ST Ward of Ex-Serviceman

OBC Sportsmen

Others

(b). Certificate Issuing authority for SC/ST/OBC and


sub-categories mentioned in column 11(a) & (b)
above:
Note:
CANDIDATE SHOULD NOTE THAT CATEGORY & SUB-CATEGORY AS CLAIMED IN SERIAL NO. 11 OF THE
APPLICATION FORM SHALL BE TREATED AS FINAL SUBJECT TO VERIFICATION AT THE TIME OF PHYSICAL EFFICIENCY
TEST (GROUND TEST) OR ANY STAGE OF RECRUITMENT PROCESS AND WILL NOT BE CHANGED UNDER ANY
CIRCUMSTANCE DURING THE RECRUITMENT PROCESS.
*12. Name of Employment Exchange where Name is registered
Registration No.:
Date of Registration: - - Validity
- -
(DD-MM-YYYY): Date

*13. Qualification / experience in the domain:………………………………………………………………………………


Kind of education in musical instrument: Formal: Informal:

 Level of formal education in music/vocal/instrumental (certificate to be attached):………………………………


 Experience in music club/band (in years):……………………………………………………………………………………………..

 List of achievement at National level (Attach Annexure):………………………………………………………………………

Sr. No. Tick the name of Instrument Please Tick here


the instrument
for which you are
applying for.
1 Bb Clarnet
2 Bb Trumpet
3 Bb Euphonium
4 Eb Bass
5 Eb alto Saxophone
6 Eb Tenor Saxophone
7 Slide Trumbone
8 Bass Drum
9 Slide Drum
*14. Mode of payment: (Application fee Rs.140/- for General Category and Rs.35/- for SC/ST/OBC/IRDP)

Bank Draft IPO

Name of Bank Name of


Post Office
Name of Branch IPO Nos.
Draft No.:
Date of issue: Date:

(i) I certify that I have read the instructions for filling the form.
(ii) I certify that information given above is true to the best of my knowledge and belief and I
understand that any wilful misrepresentation of any fact will lead to rejection of
candidature for the post of constable in HP Police Department at any stage.

Date:
Place: Signature of the Candidate

Name of the Candidate ………………………………………………………………………


Mandatory Instructions:

1 Fields marked with * are mandatory


2 The application form must be filled up by the candidate in his / her own handwriting.
3 Home address and Father’s name must be filled up in block letters.
4 For proof of date of birth, only matriculation certificate will be considered.
5 Matriculation certificate (minimum educational qualification) will be considered only from
an institution duly recognized by HP Govt./HP Board of School Education.
6 Certificate for the SC / ST/OBC/IRDP/WARD OF FREEDOM FIGHTER/ WARD OF EX-
SERVICEMAN mentioned under column No.11 should be issued by an Executive
Magistrate authorized by the HP Govt. for the purpose.
7 The cut off date for calculation of upper & lower age and reserved category certification
limit is 01.01.2019.
8 The candidate must write his name and date of birth on the back of the photograph
(coloured) before stapling on the Application Form. Total of 5 latest & passport size
photographs are required for submission with Application Form. One will be stapled on
the front page of application form, 03 will be stapled on the ANNEXURE A1 and one
spare photograph will be provided by the candidate by stapling the same with the
Application Form.
9 Candidate must have valid registration in any of the Employment Exchanges of HP on
the date of submission of application form.
10 Candidate must be a bonafide Himachali as per record.
11 Candidate must bring his original certificates and self attested photocopies of
certificates at the time of Physical Efficiency Test as well as Personal Interview. Cutting
/ overwriting / erasing / fluid corrections on the documents shall not be considered
unless attested by the issuing authority.
12 Date of PET as indicated in the call letter will not be changed.
13 The candidate must ensure that the application form reaches the office of
Superintendent of Police of the district of which candidate is a native/resident as per
record before 30th April, 2019 upto 5:00 PM by any mode including by post. The
application form is liable to be rejected if it is sent to or deposited with any office other
than the district Superintendent of Police concerned.
14 Incomplete forms will not be accepted and shall be rejected. Applications received after
5.00 P.M. on the last date of submission of the Application form i.e. on 30th April, 2019
will not be entertained.
15 Processing fee would not be refunded if the application form is rejected.
16 A processing fee of Rs.140/- (Rs. One Hundred & Forty) only shall be charged from
each candidate from the General category and Rs.35/- (Thirty Five) only be charged
from each candidate belonging to the categories of the SC/ST/OBC/IRDP. The
processing Fee can be deposited through Bank Draft / IPO by the candidate, drawn in
favour of the Superintendent of Police, Shimla, District Shimla.
ANNEXURE- A/1
PHYSICAL EFFICIENCY TEST
Attested
1. Full Name of Applicant :……………………………………………………………………..……………. photograph be
2. Father’s Name :……………………………………………………………………………………. stapled here
3. Date of Birth :…………………………………………………………………………………….
4. Tick(√) Correct Category/Sub Category:
(a) Category:
General SC ST OBC

(b) Sub
IRDP Ward of Home Sportsmen Ex- Others
Category: Freedom Guard Servicemen
Fighter

PROFESSIONAL/SKILL TEST
Attested
1. Full Name of Applicant :……………………………………………………………………..……………. photograph be
2. Father’s Name :……………………………………………………………………………………. stapled here
3. Date of Birth :…………………………………………………………………………………….
4. Tick(√) Correct Category/Sub Category:
(c) Category:
General SC ST OBC

(d) Sub Category:

IRDP Ward of Home Sportsmen Ex- Others


Freedom Guard Servicemen
Fighter

PERSONALITY TEST (SUBJECT TO DECISION OF H.P. GOVT.)


Attested
5. Full Name of Applicant :……………………………………………………………………..……………. photograph be
6. Father’s Name :……………………………………………………………………………………. stapled here
7. Date of Birth :…………………………………………………………………………………….
8. Tick(√) Correct Category/Sub Category:
(e) Category:
General SC ST OBC

(f) Sub Category:

IRDP Ward of Home Sportsmen Ex- Others


Freedom Guard Servicemen
Fighter

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