1
|
Name of the Candidate
(In BLOCK Letters)
|
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2
|
Father's/Husband's Name
|
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3
|
Mother's Name
|
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4
|
Address
|
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a
|
Permanent
|
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b
|
Present
|
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5
|
Phone No. (If any)
|
||||||||||
a
|
Land Phone
|
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b
|
Mobile Phone
|
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6
|
Date of Birth (As per Madhyamik Exam's Certificate/ Admit Card)
|
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7
|
Nationality
|
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8
|
Sex (Male/Female)
|
||||||||||
9
|
Marital Status
|
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10
|
Whether belongs to SC/ST
|
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11
|
Whether Physically Handicapped
|
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12
|
Details of Educational / Technical Qualifications
|
||||||||||
13
|
|||||||||||
14
|
Declaration of the Applicant
|
The informations given above sre trueto the best of my knowledge.
|
|||||||||
Date:
Place:
|
(Signature of the Applicant in Full)
|
||||||||||
Examinations
|
Year of Passing
|
Board/University
|
% of Marks
|
Index
(For Office Use)
|
Madhyamik or Equivalent
|
||||
H.S (+2) or Equivalent
|
||||
B.A / B.Sc / B.Com /
(2yrs / 3yrs/ Hons)
|
||||
M.A / M.Sc / M.Com
|
||||
