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Form for LDC in English

This document is an application form for the position of Lower Division Clerk at the Birla Industrial & Technological Museum, requiring candidates to provide personal details, educational background, and employment history. It includes sections for citizenship verification, family income, and additional qualifications, as well as a declaration of the truthfulness of the information provided. The application must be submitted by October 3, 2018, and includes instructions regarding supporting documents and disqualification due to canvassing.

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Sunil Hazra
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33 views3 pages

Form for LDC in English

This document is an application form for the position of Lower Division Clerk at the Birla Industrial & Technological Museum, requiring candidates to provide personal details, educational background, and employment history. It includes sections for citizenship verification, family income, and additional qualifications, as well as a declaration of the truthfulness of the information provided. The application must be submitted by October 3, 2018, and includes instructions regarding supporting documents and disqualification due to canvassing.

Uploaded by

Sunil Hazra
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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To be submitted on or before - 10/03/2018

Advertisement No. : 01/2018


Name of the News paper :
Space for
___________________________________ affixing
Passport size
recent
BIRLA INDUSTRIAL & TECHNOLOGICAL MUSEUM Photograph
(National Council of Science Museums)
Ministry of Culture, Govt. of India
19A, Gurusaday Road, Kolkata – 700 019
************************************************
Form of Application for the post of Lower Division Clerk

Shrikrishna Dhenkanal Science


Science Centre, Centre, District Science Centre,
Patna, Bihar Dhenkanal, Odisha Purulia, West Bengal

( To be filled in by the candidates with own handwriting and forwarded to the above address )
---------------------------------------------------------------------------------------------------------------------------
01. Name in full (in block letters) :
--------------------------------------------------------------------------------------------------------------------------

02. Address in full : Present :

Permanent :

Email ID :
---------------------------------------------------------------------------------------------------------------------------
03. a) Date of birth :
( in Christian era )

b) Place of birth :
---------------------------------------------------------------------------------------------------------------------------
04. Are you YES / NO

* a) a citizen of India by birth and/or by domicile ?

b) a person having migrated from Pakistan or Bangladesh


or other countries with the intention of permanently
settling in India ? or subject of Nepal or Sikkim ?

* Answer ‘Yes’ or ‘No’ and cancel the words, which are not applicable.
---------------------------------------------------------------------------------------------------------------------------
05. a) Father’s name, Occupation & address :

b) Mother’s name, Occupation & address :

--------------------------------------------------------------------------------------------------------------------------
: 2 :

06. Total income of the family per month :

07. State your


(a) Religion :
(b) Are you a member of Schedule Caste or Tribe or :
Other Backward Class ? Answer ‘Yes’ or ‘No’.
If the answer is ‘Yes’ indicate caste.
(c) Are you physically challenged? If yes, give details :
(d) Are you an Ex-Serviceman? If yes, give details:
----------------------------------------------------------------------------------------------------------------------------
08. Whether undergoing any course of studies :
( If so, give details)
09. Particulars of all examinations passed commencing from the Matriculation or equivalent
examination :
Name of the % of Division/
Examination Year of
Board/Institute/ Marks Class Subjects taken
passed passing
University obtained obtained

10. Details of type writing knowledge on : (i) English typewriting speed _________ w.p.m.
Computer
(ii) Hindi typewriting speed __________ w.p.m.

11. Any additional qualifications :

12. Experience (give details of all employment)


Nature of Name of employer Date of Date of Salary
employment joining leaving drawn
: 3 :

13. Have you any relative working in the NCSM ? If so,


please give details.

---------------------------------------------------------------------------------------------------------------------------

14. Are you willing to work anywhere in India ?


(Answer ‘Yes’ or ‘No’ )

--------------------------------------------------------------------------------------------------------------------------
15. In Case of Ex-Serviceman
a) Pension Payment Order No. :

b) ECHS Card No. :

16. PAN /AADHAR no. if any, :

--------------------------------------------------------------------------------------------------------------------------
Note :

1. Information in respect of Columns 3a, 7b, 7c, 7d, 9, 12 & 15 should be supported by
attested copies of certificates and testimonials, otherwise the application will not be
considered.

2. Canvassing in any form and/or bringing in any influence political or otherwise, will be
treated as a disqualification for the post.
--------------------------------------------------------------------------------------------------------------------------
I hereby declare that the information furnished in this application is true & correct to the best
of my knowledge and belief.

Date : Candidate’s signature_____________________________________


Telephone No.:

Candidate already employed should get the following endorsement signed by his/her present
Employer.

ENDORSEMENT BY THE PRESENT EMPLOYER (if he/she is Govt. employee)

Date______________________________________

Name_____________________________________

Full signature ______________________________ with seal

File No._______________________

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