Application Form Dgps
Application Form Dgps
Application Form Dgps
Advt. No. NH/DG/HR/RECTT/11/2013 01. 02. Name of post applied for* : ____________________________ Name (In Block Letters) First name* Middle name Fathers / Husbands Name*:
Surname*
03.
04. 05.
Date of Birth* :
Date
Month Year
age as on 08.04.2013
Year
Month
Days
06. Marital Status* : Married (Tick One) 07. Category* : SC (Tick One)
NonCreamy Layer
Creamy layer
08.
Pin * Phone No. (with STD Code) Cell Phone No. Email ID* 10. Permanent Address (In capital letters) *
Pin*
11. Nearest Railway Station (from Correspondence Address mentioned above *
12.
Institute/University
Year of Passing
%age of Marks
Remarks
Part Time
Institute/University
Year of Passing
%age of Marks
Remarks
14. Experience in chronological order starting from the present position to backward*. Sl. Name of Employer No. Post held Scale of pay IDA/CDA/any other pattern Period From To Nature of duties performed
15.
State of Domicile* :
16.
Religion*:
DECLARATION I hereby declare that all statements in the application are true, complete and correct to the best of my knowledge and belief. In the event of information being found false or incorrect, my candidature for appointment may be considered terminated without any notice. I also declare that I am citizen of India by Birth /domicile.
Place* : __________ Date* :_____________ Signature of candidate*_______________