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Application Form Ja

This document is an application form for the post of Training Associate, Junior Assistant, or Physical Training Instructor at the Rajiv Gandhi National Institute of Youth Development. It requires personal details, educational qualifications, work experience, and references, along with a declaration of truthfulness. Applicants must attach relevant documentary evidence to support their application.

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10 views4 pages

Application Form Ja

This document is an application form for the post of Training Associate, Junior Assistant, or Physical Training Instructor at the Rajiv Gandhi National Institute of Youth Development. It requires personal details, educational qualifications, work experience, and references, along with a declaration of truthfulness. Applicants must attach relevant documentary evidence to support their application.

Uploaded by

gokul
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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राजीव गांधी राष्ट्रीय युवा विकास संस्थान

Rajiv Gandhi National Institute of Youth Development


युवा कार्यक्रम विभाग / Department of Youth Affairs
युवा कार्यक्रम और खेल मंत्रालय, भारत सरकार
Ministry of Youth Affairs & Sports, Government of India
श्रीपेरुम्बुदूर Sriperumbudur – 602105 / तमिल नाडु /Tamil Nadu
-----------------------------------------------------------------------------------------------------------------------
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For office use Application for the post of Training Associate/ Junior Assistant/
APPL. No: Physical Training Instructor (On Contract)
[Purely Temporary position on Contract basis]

Please read the information carefully on website prior to filling up this application form. You
may use separate sheet/s wherever required. Documentary evidence(s) is/are to be
attached for the data provided in this application failing which due weightage will not be
given during scrutiny.

Advertisement No & Date: …………………………………………………… Please affix recent passport size photograph

Department:
Venue:

1. (i) Full Name (in BLOCK letters) : ………………………………………………………...…...………............

(ii) Father’s/Husband’s Name: ….………………………………………………………………......................

(iii) Category: …………………………………………….


Whether belonging to SC/ST/OBC/PWD, Attach Certificate.

2. Date of Birth : ……………………………… Age : ………….………. 3. (a) Nationality:…………………….…….

(b) Gender: Male / Female / Others (c) State/UT to which you belong: ……………………………….......

(d)Marital Status: ………………………………………………….............

4. Postal Address for correspondence. 5. Permanent Address (with Phone no. & Mobile):

..…………………………………………………….. ....……………………………………………………..……......

………………………………………………..…..... …...………………………………...............................

……………………………………………………..... …...………………………………..................................

..…………………...Pin Code: ………........... ……………………....Pin Code: ……….....................

Mobile No.: ………...……………….....….... E-mail ID: ……………………..………………………………

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6. Educational Qualifications (Start with SSLC):

Month & % of
Sl. Examination Name of the Subject / Marks / Division /
No. Passed University/Board Year of Specialization Grade
Passing Class
(CGPA)

7. Prizes, Awards, Rank received etc. (if any, attach certificate): ……………………...……….................

………………………………………………………………………………...................................................................

………………………………………………………………………………..........................................................................

8. (a) Post held at present:

Name & Address of Salary per month (Rs.)


Post held Date of Appointment Employer

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9. Experience (In chronological order):

Sl. Name of the Employer Period of Employment Salary per


No Post held month (Rs.)
From To

10. Any other details:

(Attach separate sheet if required)

11. Please give details of three referees (Not from the blood relation to the
candidate), At least one should be the current / previous employer:

(i) Name: ……………………………….............. (i) Name: ………………………………...................................

Designation: ………………………….............Designation: …………….……………………………………….......

Full Address: ……………………………........Full Address: ……………………………..…………..…………......

……………………………………................ …………………………………….............................................

……………………………………................... ……………………………………..............................

Contact No. …………………………….......... Contact No. ……………………………...................

E-mail: ………………………………….......... E-mail: ……………………………………………….........

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11. Any other relevant information: …………………………………………………..…………………....................
………………………………………………………………………………………………………..………………….........................
…………………………………………………………………………………………………………...........................................

DECLARATION

"I hereby declare that all the statements made in this application are true and complete to the best
of my knowledge, belief and nothing has been concealed / distorted. I am aware that, if at any time
I am found to have concealed / distorted any material information, my appointment is liable to be
summarily terminated without any notice. Moreover, if any information is found incorrect/wrong, I
shall be liable for action as decided by the Institute authority”.

Date:

Place: (Signature of Applicant)


---------------------------------------------------------------------------------------------------------------------------------

Enclosure:

S. No Description Enclosed
1. Self-attested 10 , 12th Marks statements
th
Yes / No
2. Self-attested UG, PG Degree Certificates Yes / No
3. Self-attested UG, PG Mark Statements Yes / No
4. Self-attested Community Certificate Yes / No
5. Self-attested Experience Certificates Yes / No
6. Any other certificates Yes / No

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