PROFESSIONAL DETAILS
(A) Educational Qualifications: Year of passing Qualification Specialisation School / or Subjects College / University / Institute SSC / 10th / ___ HSC / 12th / ___ Graduation Post graduation B. Ed. Any other Total marks %/ CGPA Any other relevant information
(B) Extra Qualification : Year of passing Qualification Specialisation University / or Subjects Institute Total marks %/ CGPA Any other relevant information
Details
Sr. No. 1 2 3 4 5
(D) Work experience: Last salary drawn: Gross (including PF, HRA, etc.) - Rs. _______________ (Start from last organization you were working With) No of Organisation Designation Job Reason for years responsibilities leaving (Give Month & Year) From To
Net salary
PERSONAL DETAILS 1) Date of birth 2) Age 3) Birth place 4) Gender 5) Marital Status : : : : :
6) Blood group
: : : :
11) Identification Mark On Body : 12) Category 13) Religion 14) Nationality : : : ST / SC/ OBC/ General
Yes_______ No________
If yes than give details ____________________________________________________ Name of the nominee___________________________ Do you have Driving License ? Yes_____ No_____
Details of family members: Total no. of family members: Sr. No. Name of member Candidates Age Relationship with member Educational Occupation Qualification of member of member
I hereby certify that the information provided above is accurate and recent to the date indicated below.
Date: Place:
Signature Name: