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Application Form Ta Jta Civil

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Alka Mahima Surin
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27 views2 pages

Application Form Ta Jta Civil

Uploaded by

Alka Mahima Surin
Copyright
© © All Rights Reserved
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
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ASSAM ELECTRICITY GRID CORPORATION LIMITED

OFFICE OF THE MANAGING DIRECTOR


Regd. Office:(FIRST FLOOR), BIJULEE BHAWAN, PALTANBAZAR; GUWAHATI - 781001
CIN: U40101AS2003SGC007238GSTIN: 18AAFCA4973J9Z3
PHONE: 0361-2739520Web: www.aegcl.co.in

APPLICATION FORM Affix a copy of


(TO BE FILLED UP IN CAPITAL LETTERS)
signed photograph
here and attach a
Advt. No…………………………………………………………… copy of the same
photograph with
Dated………………………………………………………………. the application

1. APPLIED FOR: TECHNICAL ASSISTANT (Civil)


JUNIOR TECHNICAL ASSISTANT (Civil)
2. NAME OF THE CANDIDATE (SHRI/SMTI): _______________________________________
3. FATHER’S/HUSBAND’S NAME: _________________________________________________
4. DATE OF BIRTH (DD/MM/YYYY): _______________________________________________
(Self-attested copies of all relevant document must be enclosed with the Application)
5. AGE ON 01/09/2022: ____________________________________________________________
6. NATIONALITY: _______________________________________________________________
7. RELIGION: ___________________________________________________________________
8. STATE OF DOMICILE: _________________________________________________________
9. GENDER: ____________________________________________________________________
10. ADDRESS FOR CORRESPONDENCE:
House No. / Street Name: _________________________________________________________
Village/ City: __________________________________________________________________
District__________________________________ State: ________________________________
Police Station: ____________________________Post Office: ___________________________
PIN: ________________________ Mobile No: _______________________________________
E-mail: _______________________________________________________________________
11. PERMANENT ADDRESS:
House No. / Street Name: _________________________________________________________
Village/ City: __________________________________________________________________
District__________________________________ State: ________________________________
Police Station: ____________________________Post Office: ___________________________
PIN: ________________________ Mobile No: _______________________________________
12. Caste/Category (Please indicate): SC ST OBC MOBC
(Self-attested copies of all relevant document must be enclosed with the Application)
13. PHOTO IDENTITY PROOF:
AADHAAR PAN CARD PASSPORT DRIVER’S LICENSE VOTER CARD
(Self-attested copies of all relevant document must be enclosed with the Application)

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ASSAM ELECTRICITY GRID CORPORATION LIMITED
OFFICE OF THE MANAGING DIRECTOR
Regd. Office:(FIRST FLOOR), BIJULEE BHAWAN, PALTANBAZAR; GUWAHATI - 781001
CIN: U40101AS2003SGC007238GSTIN: 18AAFCA4973J9Z3
PHONE: 0361-2739520Web: www.aegcl.co.in

14. EDUCATIONAL QUALIFICATION (ANNEX EXTRA SHEET IF REQUIRED):


Name of the Duration Year of Name of the Board/ Class/ % of marks
Examination Passed of Course passing University/ Institute Division obtained

HSLC or Equivalent

HSSLC or
Equivalent

Degree/Diploma
Any Other
Qualification
(Please Specify)
(Self-attested copies of all relevant mark sheets must be enclosed with the Application)
15. POST-QUALIFICATION EXPERIENCE (ANNEX EXTRA SHEET IF REQUIRED):
Name & Address of the Nature of Experience
Post Held No. of years From To
organization/Employer Job

(Self-attested copies of all relevant experience certificates must be enclosed with the Application)
16. LANGUAGES KNOWN:

Language Read Write Speak

DECLARATION

I hereby declare that the particulars furnished above are complete and correct to the best of
my knowledge and belief. I understand that if at any stage, it is found that the information given in the
application is false or incorrect or I do not satisfy the eligibility criteria, my candidature/engagement
is liable to be cancelled.

Place:
Date:
Signature of the candidate

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