Scribd
Upload
257 views

CCC / CCC Examination Registration Form: + For After Training Exam For Employees of State Government

The document is a registration form for employees of the state government to take an exam after training. It requests information such as the employee's name, designation, date of birth, address, marital status, caste, whether physically handicapped, and expected promotion timeline. The form is to be signed by the employee, head of the exam center, and head of the employee's office. It also includes an admit card section confirming exam details for the registered employee.

Uploaded by

rajnishloncha
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
257 views

CCC / CCC Examination Registration Form: + For After Training Exam For Employees of State Government

The document is a registration form for employees of the state government to take an exam after training. It requests information such as the employee's name, designation, date of birth, address, marital status, caste, whether physically handicapped, and expected promotion timeline. The form is to be signed by the employee, head of the exam center, and head of the employee's office. It also includes an admit card section confirming exam details for the registered employee.

Uploaded by

rajnishloncha
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

CCC / CCC+ EXAMINATION REGISTRATION FORM

FOR AFTER TRAINING EXAM FOR EMPLOYEES OF STATE GOVERNMENT

NOTE: ALL INFORMATION SHOULD BE FILL IN ENGLISH CAPITAL LETTERS ONLY 1 2 3 4 NAME OF SECRETARIAT NAME OF DEPARTMENT NAME OF INSTITUTE / OFFICE OFFICE ADDRESS : : : : PHONE NUMBER 5 NAME AND DESIGNATION OF HEAD OF INSTITUTE / OFFICE CONTACT NUMBERS AND E-MAIL ADDRESS NAME OF EMPLYEE ( STARTING WITH SURNAME ) DESIGNATION GPF ACCOUNT NO DATE OF BIRTH AGE DATE OF JOINING 11.1 IN GOVT . SERVICE 11.2 DEPARTMENT 12 13 14 15 16 17 18 19 DATE OF RETIREMENT PERMANENT RESIDENTIAL ADDRESS SEX MARITAL STATUS CAST WHETHER PHYSICALLY HANDICAPPES ? WHETHER EX- SERVICEMAN WHETHER LIKELY TO BE PRAMOTED / HIGHER SCALE WITH IN MONTHES : ( M) : : : : : : : : : : : : : : : : PHONE NUMBER 0- MALE / 1 - FEMALE 0 - UNMARRIDE / 1 - MARRIED 2 - DIVORCED / 3 - WIDOW 0 GENERAL / 1- SC / 2-ST/ 3- OBC YES / NO YES / NO 3 / 6 / 9 / 12 NOT APPLICABLE ( O) Passport Size Photograph

6 7 8 9 10 11

SIGNATURE OF EMPLOYEE

SIGNATURE OF HEAD OF EXAM CENTRE

SIGNATURE OF HEAD OF EMPLOYEES OFFICE

CUT FROM HERE.....................................................

ADMIT CARD
NAME OF EXAM CENTRE DATE OF EXAMINATION NAME OF EMPLOYEE SEAT NUMBER TRIAL NUMBER : : : : : 1 ( One ) / 2 ( Two) / 3 (Three) Passport Size Photograph

SIGNATURE OF HEAD OF EXAM CENTRE

SIGNATURE OF HEAD OF EMPLOYEES OFFICE

www.isisurat.org. ddc

You might also like