3/26/2019 Application

Application No : PSMED/3616/00041 Date & Time : 26/03/2019,08:20:03 PM

To
The CDPO
Dantan-II ICDS Project
PASCHIM MEDINIPUR District
Subject : Prayer for consideration of sponsoring name for recruitment of Supervisors
Sir / Madam,
In response to your notice this is to request you that I have attained eligibility for candidature to recruitment for Supervisor
under ICDS Scheme.My personal details along with certificates are attached for kind consideration.

ICDS Centre Details

Anganwadi Center Name( AWCS Name ) : Kuchaigeria Pry. School AWCS Code : 19344080818
Personal Details
Worker Name : RINKU DE MAITY Mobile No. : 9002920462
Father's Name : KANU CHARAN DE Mother Name : SANDHYA DE
Date of Birth : 28/07/1991 Age : 27 Y. 5 M. 4 D.
Marital Status : Married
Husband Name : KARTIK MAITY

Address Details
Address : VILL - KUCHAIGERIA Pincode : 721443
Post Office : BRAHMANKHALISA Police Station : BELDA
District : PASCHIM MEDINIPUR State : WEST BENGAL
Joining Details where she joined first as Anganwadi Worker
Date of Joining : 10/05/2010 Experience in years : 8 Project Name : Dantan-II
Name and Code of AWC : Kuchaigeria Pry. School ( 19344080818 )
Education Details
Sl. Year of Marks
Examination passed Name of Board/ University
No. Passing obtained
1 MADHYAMIK PARIKHYA West Bengal Board of Secondary Eduction 2006 64
HIGHER SECONDARY West Bengal Council of Higher Secondary
2 2008 61
EXAMINATION Eduction
3 BACHELOR IN ARTS VIDYASAGAR UNIVERSITY 2012 45.19
4 MASTERS IN BENGALI RABINDRA BHARATI UNIVERSITY 2014 58.25

Disability Status Details

Wheather person with disability : No
Miscellaneous Details
Meritorious Sports
Caste : OBC-B
Personality
: No

Particulars furnished above are true to the best of my knowledge and I do hereby undertake that if any of the information
furnished is found incorrect,my candidature may be rejected.
May I be allowed to appear the examination for recruitment of Supervisors under ICDS
Documents in hard copies to be submitted with the signed copy of system generated online application is given below

1) Age Proof - Madhyamik or equivalent certificate.    2) Id proof stating residential address.    3) Caste Certificate details for SC/ST/OBC A/OBC
B.      4) Document for Meritorious Sport Personality (If yes).      5) Proof of Educational Qualification Details and Examination Passed Mark
sheet.    6) Certificate from CDPO of first Project Stating date of joining.    7) Disability Certificate and ID card details for person with disability
candidate.

___________________________________
Applicant's Signature & Date
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For Official Use only
Application Id : PSMED/3616/00041
Applicant Name : RINKU DE MAITY
Application Date : 26/03/2019
Hard Copy received Date :
Hard Copy received Time :
____________________________________
CDPO Signature with Seal

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