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Application Form

Instructions:(Please read the following instructions carefully, before ling in the form)1. his form is to be lled by candidate only!. Please attach photocopy of all rele"ant certicates.

#a"e you e"er been inter"iewed before at $%&' $oshion td* +' ( ) - ( )If yes, then answer the following/$ate of per"ious inter"iew/$i"ision Applied for/Inter"iewer0s -ame/

Post applied

for/

$i"ision/ $ate of

Inter"iew/

Personal $etails/-ame in full (23 4') / 5r.5s.5rs. /

'urname/ First name/ 5iddle name /

mail I$/

Present Address / Permanent Address /

andline -o./ andline -o./

5obile-o.

6 mergency 2ontact -o./

$ate ofirth/

Age/ #eight/

Place of

irth/

'e7/ &eight/

'tate/ 4eligion/

Physical #andicap if any/

-ationality/

2aste/ 5a8or 5inor surgery in past/

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ye sight/ lood9roup/

5a8or illnessdiseasein last three years/

FA5I+ $AI'/5arital 'tatus (: mar; the applicable)/ ( ) 'ingle, ( ) 5arried, ( ), &idow, ( ), &idower, () $i"orcee.4elation with you/ -ame $ate of

irthAge ccupatio

nIncome(Per Annum)

1 'pouse

! 2hildren (if any)(a)

(b)

< Father

= 5other

> rother 'ister

? Any otherdependentfamilymember

$etails of ducational @ualication (Ascending rder)/

'r.-o.

7amination2leared

'chool 2ollege ni"ersity

2lass $i"ision

B of5ar;s

'ub8ects +ear ofpassing

1

!

?

-ote/ Furnish e7act details of any drop in your ducational career e.g. Failure, non

appearance etc.Particulars of specialtraining under gone/Any %isit abroad*If so, gi"e details/$o you posses a passport*If any, pro"ide details/

Passport-umber/

%alidity

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$o you own a two fourwheeler* If any, pro"idedetails/

$ri"inglicense-o./

%alidity

$o you ha"e PA- 2ard* Ifyes, please pro"idedetails/

PA--o./

'r.-o.

2omputer Prociency 2erticate A"ailable (Put :)

+' -1

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