APPLICATION PROFORMAToChief Workshop Manager(Personnel),Mechanicial Workshop,N.E. Railway, Gorakhpur.

Sub:- Application for selection of Trade Apprentice Trainees.

Ref:- Notification No. E/227/IV/5/Pt.X.V dated 02.06.2015**********

In reference to above notification I hereby submit my application for selection as Trade Apprentice Trainees and I also governed by the provision made in Apprentice Act, 1961 and revised time to time.

1. Name of Applicant: …………………………………………………….

2. Father’s Name : ………………………………………………………

3. Permanent Home Address: ……………………………………………..

Vill./Moh.…………………………P.O. ………………. Distt. …………………….

State……………………………Telephone No. …………………….…………………

4. Address for Correspondence: ……………………………………………………

Vill./Moh.…………………………P.O. ………………. Distt. …………………….

State……………………………Telephone No. …………………….……………..

5. Nationality ………………………………….Caste………………………Religion……………………..

6. Whether SC/ST/OBC submit the caste certificate duly attested by Gazetted Officer.

7. Date of Birth: ………………………………… submit attested copy of certificate.

8. Age of Applicant Year…………… Month …………………… Days………………………

9. Married/unmarried…………………………………………………………………………

10. QualificationExam Year Name of Institute Subject % of

MarksName of Education Board

In support of above qualification applicant should submit attested copy of marksheet and certificate.11. Any other qualification:- …………………………………………………………………………………

12. Two marks of identification:- ……………………………………………………………………………..

13. Character certificate issued by two Gazetted Officer.

14. If applicants father is Rly Employee submit the Department certificate in this connection on enclosed proforma.

Signature of Candidate

Self sign.

photo

APPLICATION FORM FOR THE ACCEPTANCE OF PATWARI CANDIDATES IN SETTLEMENT DEPARTMENT HIMACHAL PRADESH.

1. Name of the Candidate:- ________________________________________ (In Block letters)2. Father’s Name:- _______________________________________

3. Date of Birth:- ________________________________________

2. Correspondence Address

House No/Village :- _______________________________________

Post Office/Tehsil/Sub-Tehsil ____________________________________

District:- ________________________________________________

State:- ________________________________________________

Pin Code:- ________________________________________________

Contact Number:- ________________________________________________

3. Permanent Address

House No/Village :- ________________________________________________

Post Office/Tehsil/Sub-Tehsil /_______________________________________________

District:- ________________________________________________

State:- ________________________________________________

Pin Code:- ________________________________________________

Contact Number:- ________________________________________________

4. Category/Sub-category to which He/ She belongs_________________________________________

5. Educational Qualification:- ______________________________________________________

6. Any other qualification /experience:- ______________________________________________

7. Fee Rs.______________ Demand Draft No.__________________________ Date_____________

8. Whether registered in any employment exchange Yes/ No:- ________________________

9. If Yes, Registration No. and name of the employment exchange:- ______________________

__________________________________________________________________________

10. I hereby declare:-

(a) That I am not involved in any criminal case and no criminal proceedings are contemplated against me in any court of law.

(b) That the above particulars mentioned in the application are correct and true to the best of my knowledge and belief. If particulars mentioned by me are found false at any stage, then my candidature I shall be liable to be terminated without any notice.

Dated :- (Signature of the applicant)

Affix recent passport size photograph duly attested by a Gazetted officer