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Application Form

This document is an application form for a joint employment notice for railway recruitment. It requests information such as the candidate's name, father's name, date of birth, age, visible identification marks, education qualifications, address, nearest railway station, community, and signature. Photograph and thumb impression spaces are also provided. Instructions note that applications must be on A4 paper and contain signatures and information as per the candidate's matriculation certificate.

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rakesh_sharma
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© Attribution Non-Commercial (BY-NC)
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138 views

Application Form

This document is an application form for a joint employment notice for railway recruitment. It requests information such as the candidate's name, father's name, date of birth, age, visible identification marks, education qualifications, address, nearest railway station, community, and signature. Photograph and thumb impression spaces are also provided. Instructions note that applications must be on A4 paper and contain signatures and information as per the candidate's matriculation certificate.

Uploaded by

rakesh_sharma
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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Annexure-1

RAILWAY RECRUITMENT BOARD______________ Roll No. (For official use only)

APPLICATION FORM FOR JOINT EMPLOYMENT NOTICE NO.01/2009 Control No.: (For official use)
PLEASE FILL UP THE APPLICATION IN CAPITAL LETTERS IN OWN HANDWRITING.
Signature should not be in Capital letters.
Paste (do not pin or staple)
(All applications must be submitted in A4 size 80 GSM paper) (bond paper) here your recent colour passport size
photograph of size 4 cm x 5 cm
1. CATEGORY No. & POST (The colour photograph
(for single category) Cat. No. Name of Post should not be more than
3 months old)
Indicate options below in order of preference where single application is prescribed for Not to be attested
more than one category (you will only be considered for the post(s) indicated below)

Option Cat. No. Post Option Cat. No. Post


1 3
2 4
Signature of candidate in the above
2. Choice of Railway 1st 2nd 3rd box below the photograph
(wherever applicable)

3. NAME OF CANDIDATE

4. COMMUNITY (Tick 3) UR OBC* SC ST


*OBC Certificate to be submitted in the form as prescribed in Annexure-4 of Employment Notice. OBC Certificate older than one year from the date of closure of Employment Notice and
without Non-creamy layer certification is not valid and will be rejected

5. FATHER'S NAME

6. DATE OF BIRTH (DD/MM/YYYY)

7. AGE (as on 01.07.2009 ) years month days


(Refer para 2 of Employment Notice)
8. VISIBLE MARK OF IDENTIFICATION ON BODY
(To be filled compulsorily)
9. Qualification (Fill in only those qualifications prescribed for the posts applied for)
Year of
(A) Academic Qualification University / Board Subjects Marks %
passing
SSC / X / Matric
Higher Secondary / XII / Inter
Graduation
Post Graduation
Others
Year of
(B) Technical Qualification University / Board Discipline / Trade Marks %
passing
I.T.I/Act Apprentice
Diploma
Engineering Degree
Others

10. ADDRESS
(FOR CORRESPONDENCE)

State............................................................................... PIN CODE

11. NEAREST RAILWAY STATION


(For issue of free Railway pass to
SC/ST candidates)

Left hand Thumb Impression


of candidate in this box —>
Signature of the Candidate
(Not in Capital letters)
Note : 1) Candidates must fill up their name, father's name and date of birth as indicated in their Matriculation Certificate.
2) Candidates should put their full signature at all the places in the same language (in English or in Hindi).

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