Scribd
Upload
49 views2 pages

Proforma of Application For The Post of " "

This document contains a proforma or application form for the post of "1". It requests basic personal information such as name, father's name, date of birth, gender, domicile status, educational qualifications, experience, caste status if applicable, contact information, disability status if applicable, current employment status if serving, list of enclosures, and declaration of truth of information provided and consent to cancellation of candidature if found false.

Uploaded by

Lokesh Parganiha
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
49 views2 pages

Proforma of Application For The Post of " "

This document contains a proforma or application form for the post of "1". It requests basic personal information such as name, father's name, date of birth, gender, domicile status, educational qualifications, experience, caste status if applicable, contact information, disability status if applicable, current employment status if serving, list of enclosures, and declaration of truth of information provided and consent to cancellation of candidature if found false.

Uploaded by

Lokesh Parganiha
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

PROFORMA OF APPLICATION FOR THE POST OF " 1. Name of applicant (in BLOCK letters) 2. Father's/ !s"an#$s Name %.

&ate of Birth '. ()e as on 01/01/2014 Y M *. +e, (mention co#e 1 for .ale an# 2 for Female) /. 0hether1 "onafi#e resi#ent of Chhattis)arh (3f 4es1 enclose the atteste# cop4 of #omicile certificate iss!e# "4 the competent a!thorit4.) 5. 6#!cational 7!alification : S. No. Name of Exam. Boa !/ "#$%e &$'( Yea of )a&&$#* D : : (ffi, Affixrecent recent

"

passport siCe passport size photo)raph photograph #!l4 atteste# : duly self "4 a attested EaCette# Officer

2es

/ No

D$%.+

8. 6,perience (if an4)

9. 0hether : (please tic: ;hiche<er is applica"le ) +C += OBC >N?6+6?@6&

(3n case of +C/+=/OBC1 enclose the atteste# cop4 of Caste Certificate iss!e# "4 the competent a!thorit4.) 1A. Bostal a##ress 11. Bermanent a##ress 12. Bhone/.o"ile no. (if an4) 1%. 0hether1 Bh4sicall4 &isa"le# :. :. :. :.. :.. :.

3f 2es1 mention t4pe an# percenta)e of &isa"ilit4: ................. 1'. 0hether1 the can#i#ate is ser<in) in : 2es / No )o<t./semi )o<t. or)aniCation (3f 4es1 application m!st "e sent thro!)h proper channel or alon)-;ith No O"Dection Certificate of the sai# #epartment) 1*. List of enclos!res :1. . %. . *. . 2. . '. .

DECLARATION 3 #o here"4 #eclare that the statements ma#e in this application are tr!e1 complete an# correct to the "est of m4 :no;le#)e an# "elief. 3n the e<ent of an4 information "ein) fo!n# false or incorrect:- (1) "efore or after test / inter<ie; / selection / appointment to the sai# post m4 can#i#at!re / appointment ;ill "e lia"le to "e cancelle#/ (2) after Doinin) ser<ices to the sai# post m4 ser<ice shall "e lia"le to "e terminate#. Blace : &ate:

,S$*#a'- e of A)).$/a#'0

You might also like