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SJVN Limited: / SSC Certificate)

This document is an application form for a job posting at SJVN Limited, a joint venture of the Government of India and Government of Himachal Pradesh. The form requests personal details such as name, date of birth, contact information, education history, and other qualifications. It also asks for information on the applicant's category, any physical disabilities, past convictions, and a declaration of truthfulness. The applicant is instructed to enclose proof of identity, caste or tribe certificates if applicable, certificates supporting their qualifications and experience, and a permanent residency certificate.

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Jeshi
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0% found this document useful (0 votes)
68 views2 pages

SJVN Limited: / SSC Certificate)

This document is an application form for a job posting at SJVN Limited, a joint venture of the Government of India and Government of Himachal Pradesh. The form requests personal details such as name, date of birth, contact information, education history, and other qualifications. It also asks for information on the applicant's category, any physical disabilities, past convictions, and a declaration of truthfulness. The applicant is instructed to enclose proof of identity, caste or tribe certificates if applicable, certificates supporting their qualifications and experience, and a permanent residency certificate.

Uploaded by

Jeshi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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SJVN Limited

(A joint venture of Govt. of India & Govt . of H.P)


An ISO 9001:2000 Company & A Mini Ratna & Schedule A PSU

Affix recent

APPLICATION FORMAT
(Use Block Letters Only)

Advt. No. 73/2014

passport size

(Please fill up this form with utmost care)


Incomplete Application form is liable to be rejected.

Photograph

Post applied for: ________________________________

here
th

A. PERSONAL DETAILS: 1. Name (as appears in 10 / SSC certificate)


Please put a space between your first name, middle name (if any) and last name.

2. Fathers
Name
3. Date of Birth

DD

4.

Age as on closing date

5.

State of Domicile:

6.

Name of Tehsil :

MM

YYYY

Yr

Month

Days

Sex: (Write M or F)

Himachal Pradesh

B. CORRESPONDENCE ADDRESS:
City/Town:

State

STD Code

Pin Code:

Telephone Number

C. PERMANENT ADDRESS:

City/Town:

State

STD Code

Pin Code:
Telephone Number

Tehsil

Mobile No.

D. ACADEMIC PERFORMANCE :
1.
Exam
Passed

Basic Qualifications Matriculation onwards:


Institution/
University/
Board

Subjects studied/ Branch of


Specialization

Duration of
study

Month & Year


of passing
(MM/YYYY)

Aggregate%
of marks *

Full Time /
Part Time/
Correspondence

2.

Professional Qualifications (Please mention qualification which makes you eligible)

3. Additional Qualification (if any)


Exam
Passed

Institution/
University/
Board

Subjects studied/ Branch


of Specialization

Duration
of study

Month &
Year of
passing
(MM/YYYY)

Aggregate%
of marks *

Full Time /
Part Time/
Correspondence

(*If it is Cumulative Grade Point Average (CGPA), please convert it to % of Marks)

E. Category:

GEN/SC/ST/OBC/Ex-ser

F. Are you physically handicapped (Yes/No?)


If yes please mention the details as follows:

Type of handicap:

Extent of disability as specified in the disability certificate:

G. Have you ever been convicted by any court of law or any disciplinary proceedings/enquiry is pending
against you or any penalty has been imposed upon you? If yes, give details.

Declaration:
I affirm that the information given in this application is true and correct to the best of my
knowledge and belief. I further undertake that if at any stage it is discovered that an attempt has
been made by me, will fully to conceal or misrepresent the facts, my candidature/appointment
shall be summarily rejected or terminated without any notice.
Date: _______________________

Signature:________________________

Place: ______________________
Name: _______________________
Please Enclose:
1.
2.
3.

Proof of SC/ST/OBC/PWD/ Ex-Servicemen/State Domicile Certificate. In case of OBC,


Non- Creamy Layer Certificate.
The candidates should also enclose attested/self-attested certificates in support of age,
educational qualifications, experience etc. along with their applications.
Certificate of permanent residentship issued by the concerned SDM.

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