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To Be Filled by The Candidate in His/her Own Handwriting in Capital Letters With Black Pen

The document appears to be an application form for a job posting. It requests information such as the candidate's name, address, date of birth, educational qualifications, experience, and other personal details. The form states that candidates must affix a recent passport photo and sign across the form and photo. It also notes that the statements made in the application should be true and correct, and any misrepresentation could result in cancellation of candidature or termination of employment.

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Sneha Adepu
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28 views

To Be Filled by The Candidate in His/her Own Handwriting in Capital Letters With Black Pen

The document appears to be an application form for a job posting. It requests information such as the candidate's name, address, date of birth, educational qualifications, experience, and other personal details. The form states that candidates must affix a recent passport photo and sign across the form and photo. It also notes that the statements made in the application should be true and correct, and any misrepresentation could result in cancellation of candidature or termination of employment.

Uploaded by

Sneha Adepu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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APPLICATION FORMAT CANDIDATES TO AFIX

THEIR RECENT
(To be filled by the candidate in his/her own handwriting in capital letters with black pen) PASSPORT SIZE
COLOUR
Advertisement No. R &D/89/18 PHOTOGRAPH AND
SIGN ACROSS FORM
I hereby apply for the post of AND PHOTO.
.

Sign here (in the box)

1 CANDIDATE’S NAME (AS RECORDED IN


MATRIC / SECONDARY SCHOOL
CERTIFICATE)
2 PARENT’S / SPOUSE’S NAME

3 FULL POSTAL ADDRESS FOR


COMMUNICATION WITH PIN CODE

P I N

4 DATE OF BIRTH (IN FIGURES) D D M M Y Y Y Y 5 AGE AS ON 31.01.2018

6 CATEGORY (PLEASE TICK) SC ST OBC GEN 7 WHETHER PH (PLEASE TICK) PH

8 IF PH PLEASE SPECIFY NATURE OF HUNCHBACK DEFORMITY OF CHEST 9 % AGE OF


DISABILITY (PLEASE TICK) DISABILITY
10 STATE OF DOMICILE

11 NATIONALITY 12 RELIGION

13 CONTACT NO 14 E MAIL

15. EDUCATIONAL QUALIFICATION (MATRIC / 10th ONWARDS) –

DURATION OF COURSE – YEAR OF MARKS IN


NAME OF BOARD / UNIVERSITY EXAM PASSED
IN YEARS PASSING PERCENTAGE

16. DETAILS OF EXPERIENCE, IF ANY

NAME AND ADDRESS OF PERIOD


POST HELD NATURE OF JOB SALARY P/M REASONS FOR LEAVING
EMPLOYER FROM TO

17. DETAILS OF APPLICATION FEE, IF APPLICABLE

DEMAND DRAFT NAME OF DATE


NO ISSUING BANK

I hereby declare that I have read all the conditions mentioned in the advertisement and I fulfill the same. The statements made in this application are true, complete
and correct to the best of my knowledge and belief. I understand that in the event of any particular or information given herein being found false or incorrect, my
candidature is liable to be cancelled and in the event of any mis-statement / discrepancy in the particulars being detected after my appointment, my service is liable
to be terminated without any notice to me.

Date: ……………. Signature………………………


Place: ………………….

Note:
1. The application must attach the following documents (no other certificate to be attached):
a. Attested copies of Matric,/10th Pass Mark-sheet & Certificate
b. Engineering Mark-sheets (all Semesters) & Certificate (for the post of Engineering Assistant)
c. Experience Certificate ( if any )

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