Application Form
Application Form
Application Form
Applicant
a Examination
Passed
b Year of Passing
c Name of the
college/ institute
d University / Board
e Main Subjects
f Remarks (% of
marks, division
etc.)
12. Details of experience (in chronological order), enclose a separate sheet, duly
authenticated by your signatures, if the space below is insufficient.-
13. Whether Education and other qualification required for the post are satisfied. (if
any qualification has been treated as equivalent to the one prescribed in the rules,
State the authority for the same)
14. Additional information, if any, which you would Like to mention in support of your
suitability for the post (This among other things may provide information with regard to
(i) additional academic qualifications, (ii) professional training, (iii) work experience
over and above prescribed in the vacancy advertisement [enclose a separate Sheet,
duly authenticated by your signatures, if the space is insufficient]
DECLARATION
I have carefully gone through the vacancy circular/ advertisement and I am well aware
that the Curriculum Vitae duly supported by documents submitted by me will also be
assessed by the Selection Committee at the time of selection for the post.
I also hereby solemnly declare and undertake that all information furnished by me is
true, correct and complete to the best of my knowledge and belief. I undertake that, if
at any stage of selection or even after selection, any of the information furnished by
me is found to be false, incorrect or misleading, then my candidature/ appointment/
services will stand cancelled/ terminated without assigning any reasons thereof. I am
fully aware that this appointment is on contract basis and I do not have any claim for
confirmation or absorption in NHAI & this appointment shall be terminated at any time
without assigning any reasons thereof.
Signature ----------------------------------
Date :----------------
Place : --------------