APPLICATION FORMAT

Advt. No.:------------------ Item No. :----------------------------Year:------------------------Name of the post applied for :------------------------------------------------------------------Affix self attested recent 1 Full Name (in capitals):------------------------------------passport size 2 Date of Birth (in figures and Words): --------photograph 3 4. 5. 6. 7. 8. 9. 10. Age as on 10.5.2011 --Gender:- Male, Female Nationality ----------------Fathers Name ( in Block Letters)---------Permanent Address-----------------Address for correspondence with contact Tel Ph. Number------------------Whether belong to SC/ST/OBC/General . ..

All educational and professional qualifications. ( Bachelors Degree onwards):

Sl NO.

Exam/degree passed

Year of Passing

Division/Grade % of Marks

Duration of the Degree/Diploma

Name of Board/Univ.

Subjects

Subject of specialisation

11. Any other specialized training course under taken :.

12. Details of Employment/Experience in the relevant fields in chronological order:

SL NO.

Office/Inst. Firm. .

Post held

PERIOD From To

Scale of pay

Nature of duties

13. Any other relevant information: (attach extra sheets).. 14. Details of enclosures: attested photocopies of documents in support of the information supplied in above columns such as Educational Qualification, Date of Birth, SC/ST/OBC certificate, Experiences etc.

15.

I hereby declare that all the statements made in the application are true and complete to the I understand that action can be taken against me by the

best of my knowledge and belief.

Corporation(DTC) if I am declared by them to be guilty of any type of misconduct or furnishing false information mentioned herein.. Date:---------Place:----------------Signature of the Candidate.