THE KOLKATA MUNICIPAL CORPORATION

Office of the Chief Municipal Health Officer

*, *. *. ******** ****, Kolkata – 700 013

Application Format for the post of Analyst for Modified Food Safety on Wheels (FSW) 1. 1. Name in full (in capital letters):

2. Guardian’s Name:

3. a) Date of Birth according to Madhyamik: __ __/__ __/__ __ __ __ Or equivalent examination certificate

b) Age as on 01.01.2023: __ __ year.

4. Are you Physically Handicapped, write Yes or No: 5. Are you Meritorious Sports person, write Yes or No: 6. Caste Category: (UR/SC/ST/OBC-A/OBC-B) of West Bengal: 7. Postal Address (in Capital Letters) :

8. Permanent address (in capital letters):

9. Contact No:

10. Email Id :

11. a) Whether citizen of India, write Yes or No:

b) Whether a natural citizen of India or citizen by registration: 12. Existing Employer Name (if any):

13. Joining Date of Existing Employer:

14. Educational/Qualifications:

Name of the

Exam

Name of the

Board/University

Full Marks Marks

Obtained

% of

Marks

Division/

Grade

Year of

Passing

Madhyamik

Higher Secondary

15. Professional / Other Qualifications or Specialization: Name of the

Exam

Name of the

Board / University

Registration No Full

Marks

Marks

Obtained

% of Marks Year of

Passing

Graduation

Post Graduation

16. Details of Experience :

Declaration

I do hereby declare that all the statements given above by me are true and correct in all respect. If any statement found false at the time of examination/interview or after my appointment then my candidature will liable to be cancelled or my service will terminate automatically. Place : Full Signature of the candidate

Date :

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THE KOLKATA MUNICIPAL CORPORATION

Office of the Chief Municipal Health Officer

5, S. N. Banerjee Road, Kolkata – 700 013

Application Format for the post of Driver for Modified Food Safety on Wheels (FSW) 1. 1. Name in full (in capital letters):

2. Guardian’s Name:

3. a) Date of Birth according to Eight Pass Certificate: __ __/__ __/__ __ __ __ Or equivalent examination certificate

b) Age as on 01.01.2023: __ __ year.

4. Are you Physically Handicapped, write Yes or No: 5. Are you Meritorious Sports person, write Yes or No: 6. Caste Category: (UR/SC/ST/OBC-A/OBC-B) of West Bengal: 7. Postal Address (in Capital Letters) :

8. Permanent address (in capital letters):

9. Contact No:

10. Email Id :

11. a) Whether citizen of India, write Yes or No:

b) Whether a natural citizen of India or citizen by registration 12. Existing Employer Name (if any):

13. Joining Date of Existing Employer:

14. Educational/Qualifications

Name of the

Exam

Name of the

School / Board

Full Marks Marks

Obtained

% of

Marks

Division/

Grade

Year of

Passing

Eight Pass

Madhyamik

15. Driving Lincence No :

16. Driving Lincence Renewal Date:

17. Details of Experience :

Declaration

I do hereby declare that all the statements given above by me are true and correct in all respect. If any statement found false at the time of examination/interview or after my appointment then my candidature will liable to be cancelled or my service will terminate automatically. Place : Full Signature of the candidate

Date :

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