Format Part2
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PART-II DETAILED PARTICULARS
ADVT. NO.:______________ ITEM NO.:___________
1.
Name of the Post:________________________________________________________________________
2.
Address for Correspondence: _______________________________________________________________
3.
Citizenship: _____________________________________________________________________________
4.
Father’s Name: __________________________________________________________________________
5.
Date of Declaration of Result of EQ(i) and EQ(ii): ______________________________________________
6.
Choice of Centre (If Applicable): ____________________________________________________________
7. All Educational/other professional Qualifications/Training Courses etc. (Starting from EQ(i) onwards) Level Exam passed/ Division/ Year of Duration of the Board/Univ. Subject Subject of Degree Trg. Grade Passing Degree/Diploma Specialisation
8. Details of employment in chronological order Office/Instt. Post Ad-hoc/ Exact dates to be Firm held Regular/ given Temp./pmt. From To
Total Period (in years)
Scale of pay
Nature of duties
9.
Complete Postal address of the present employer (wherever applicable)
----------------------------------------------------------------------------------------------------------------------
10.
Date of completion of compulsory rotating internship ----------------------------------------------------------------(To be filled in case of Medical posts only)
Any other relevant information: (attach extra sheets) Details of enclosures: 1)--------------------------------------------------------------------2) -------------------------------------------------------------------3) -------------------------------------------------------------------I hereby declare that all the statements made in this applications are true and complete to the best of my knowledge and belief. I understand that action can be taken against me by the Commission if I am declared by them to be guilty of any type of misconduct mentioned herein. I have informed my Head Office/Deptt. in writing that I am applying for this selection. Signature of the candidate Name _____________________ Place : Date :
ADVT. NO.:______________ ITEM NO.:___________
1.
Name of the Post:________________________________________________________________________
2.
Address for Correspondence: _______________________________________________________________
3.
Citizenship: _____________________________________________________________________________
4.
Father’s Name: __________________________________________________________________________
5.
Date of Declaration of Result of EQ(i) and EQ(ii): ______________________________________________
6.
Choice of Centre (If Applicable): ____________________________________________________________
7. All Educational/other professional Qualifications/Training Courses etc. (Starting from EQ(i) onwards) Level Exam passed/ Division/ Year of Duration of the Board/Univ. Subject Subject of Degree Trg. Grade Passing Degree/Diploma Specialisation
8. Details of employment in chronological order Office/Instt. Post Ad-hoc/ Exact dates to be Firm held Regular/ given Temp./pmt. From To
Total Period (in years)
Scale of pay
Nature of duties
9.
Complete Postal address of the present employer (wherever applicable)
----------------------------------------------------------------------------------------------------------------------
10.
Date of completion of compulsory rotating internship ----------------------------------------------------------------(To be filled in case of Medical posts only)
Any other relevant information: (attach extra sheets) Details of enclosures: 1)--------------------------------------------------------------------2) -------------------------------------------------------------------3) -------------------------------------------------------------------I hereby declare that all the statements made in this applications are true and complete to the best of my knowledge and belief. I understand that action can be taken against me by the Commission if I am declared by them to be guilty of any type of misconduct mentioned herein. I have informed my Head Office/Deptt. in writing that I am applying for this selection. Signature of the candidate Name _____________________ Place : Date :
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