application-chennai.pdf

8/18/2019 application-chennai.pdf

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CORPORATION OF CHENNAI, RIPON BUILDING, CHENNAI - 600 003.

APPLICATION FOR THE POST OF ASSISTANT ENGINEER

(MECHANICAL) / (CIVIL) / (ELECTRICAL) & SANITARY INSPECTOR

APPLICATION FOR THE POST OF

1.Name in full (Block Letters)

2.Father’s / Husband’s Name

3.Gender(Tick the relevant box)

Affixed Photo

should beattested by the

gazetted officer

Male Female Third Gender

4.Marital Status(Tick the relevant box)

Married Unmarried Widow

5.Full Postal Address with Mobile No. & email-id

a) Permanent Address:

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Pincode:

District: Mobile No: email-id:

b) Address for correspondence

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Pincode:

District: Mobile No: email-id:

6.Nationality : Religion :

7. a) Date of Birth : b) Age :D D/ M M/ Y Y Y Y

(Self attested copy of High School Certificate showing

Date of Birth must be enclosed)

8.a) Mother tongue :

(Please mentioned if Tamil is not mother tongue)

b) Second Language in School :


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9.Category [SC(A)/SC/ST/MBC/BC/BC(M)/OC] :(Self attested copy of Caste Certificate to be enclosed)

10.EDUCATIONAL QUALIFICATION

(Self attested copy of all Educational Qualifications to be enclosed)

Sl.No. Qualification Register No. Year of Marks, Grade Nam of the InstitutionPassing obtained with class

Grade % Class

1. SSLC / MATRIC

2. HSC

11.PROFESSIONAL / TECHNICAL QUALIFICATION

(Self attested copy of Certificates as Proof)

Sl.No. Qualification Register No. Year of Marks, Grade Name of the Institution

Passing obtained with class

Grade % Class

1.

2.

12. a) Wheather Ex-servicemen

b) If yes, please furnish the detail and

enclosed self attested copy of discharge certificate

Date of Entry in Armed Forces Date of Discharge Number of Years Service rendered

13.Wheather Destitude Widow : (YES / NO)

14.If candidate belonging to Differently abled persons : (YES / NO)

Type of PH Percentage of PH Certificate No. Name of Issuingand Date Medical Authority

15.EXAMINATION FEES

DD No. Date Name of the Bank & Branch Amount


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16.OTHER DETAILS, IF ANY

Note : Stage of the case at the time of applying, Nature of the criminal charge, if acquitted on the date of this

application date of judgement should be given. (Tick the relevant box)

Section of Law

Pending Stage of Case YES NO

Acquitted YES NO

Date of Acquitted

D D M M Y Y Y Y

PARTICIPATION IN POLITICAL

In agitation YES NO

As member of Political YES NO

Organisation

Candidate in Election YES NO

Note :

Qualification for the post :

1)

Assistant Engineer (Mechanical) : A degree in Mechanical Engineering / B.Tech (Mechanical )/ Auto Mobile Engineering /MechatronicsEngineering OR

A pass in Sections A and B of the Institution Examinations(A.M.I.E) under Mechanical Engineering Branch

2) Assistant Engineer (Civil) : B.E. Civil Engineering /B.Tech(Civil)/B.E. Structural EngineeringOR

A pass in Sections A and B of the Institution Examinations (A.M.I.E)under Civil Engineering Branch.

3) Assistant Engineer (Electrical) : A Degree in Electrical Engineering/ Electronics andCommunication Engineering / Information Technology /Instrumentation Engineering / Computer Science

OR

A.M.I.E under Electrical Engineering Branch.

(Recruitment for theDegree in Electrical & Electronics Engineering - 14 VacanciesDegree in Electronics and Communication - 5 VacanciesDegree in Instrumentation Engineering - 2 VacanciesDegree in Information Technology /Degree in Computer Science) - 2 Vacancies


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4) Sanitary Inspectora) Must have minimum qualification of B.Sc. Degree (main subject Chemistry) from the RecognizedInstitution approved by Government.b) P.G. Diploma in Sanitary Inspector course conducted by the Institutions recognized by the Government.c) Certification in Computer course.

Check list of Enclosures (Tick the relevant Column)

Sl.No. Documents Yes No Not applicable

1. Passport size photos (Colour) 3 Nos (1 pasted

on application form, 1pasted on hall ticket and

1to be enclosed with application

2. Date of Birth (SSLC / Matric passed Certificates)

3. Educational Qualifications 10th

(Certificates & Marksheets)

HSC

Degree

4. Community Certificate

[SC(A)/SC/ST/MBC/BC/BC(M)/OC] –

in prescribed proforma

5. No Objection Certificate (in case of Departmental

candidates)

6. Differently abled persons Certificate in prescribedproforma for Employment in State Government

7. Discharge Certificate (in case of Ex-servicemen)

8. Whether all above documents / certificates are

self attested

Signature of the Candidate

Date :

Place:


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DECLARATION

I hereby declare that all the statements made in this application are true and correct to the best of myknowledge and belief. In the event of any information being found false / incorrect or ineligibility

deducted before or after the written test / certificate verification or even after appointment, my

candidature / appointment will stand automatically cancelled.

Signature of the Candidate

Date :