Higher Secondary qualified

PROFORMA

Application for the post of

BIO-DATA

*. Name (In Block Letters). 2. Father’s Name. 3. Date of Birth (In Christian era) In numerals: In words:

4.

(a) Address for Correspondence.

(b) Contact Telephone Number.

(c) E-Mail ID, If any. 5. Permanent Address.

6. Nationality & Religion.

7. Whether SC/ST/OBC/General.

8. Marital Status. 9. Educational Qualification.

Examination

Passed

Name of

University

Year Subject Marks Class/ Division/ % of

Marks

9 A: Computer Knowledge:

10. Experience:

Sl.

No.

Name of

Post

Name of the

Organization

Nature of Job

Assigned

Pay Drawn & Scale

of Pay Before

Leaving

From To

11. Are you under contractual obligation to serve the Central Govt./State Govt./any other Public Sector Undertaking? If so, please furnish full details: 12. Any other information you may wish to add: I hereby certify that the information given above is true and correct. In case any information is found to be false, I am aware that in case of my appointment, the same is liable to be terminated as per the terms and conditions of appointment. Place: Signature:

Date:

Attested copies of certificates to be enclosed:

1. Date of Birth;

2. Educational Qualifications;

3. Community Certificate:

4. Experience Certificate;

5. Computer Literacy Certificate;

6. Any other certificate.

* * * * *

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