Guide
Guide
Guide
10. Tick (√ ) the Serving Railway Divorcee/ Minority Economically Weaker Residents of Jammu &
applicable box, if Employee Widow Community Section Kashmir
you are:
State: PIN
16. Exam Fee Details: 17. Left Hand Thumb Impression.
DD/IPO No./Date Amount (Rs.)
19. Member of the Group for at least 5 years in the recent past:
Year Name of the Group Position held/Rank Date Warrant No. (If any) and
From To date
2019
2020
2021
2022
2023
Photocopy of the certificates regarding activities for last 5 years in recent past to be attached duly certified by the State/District
Commissioner (Scouts) for Scout wing and State/District Commissioner (Guides) for Guides wing./ Active membership certificate
should be furnished in Annexure-III.
…………………………………………………………………
20. Applicant’s full signature in running script (in Hindi or English)
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APPLICATION FORM : E.N.No. ECoR /Pers/S&G/2023-24 dated 01.02.02024 Annexure-II
21. Particulars regarding Participation/Service rendered in National events/National Jomboree (including All Indian
Railway Events)
Sl. Event Certificate No. Date of Issue Issued by
No.
1
2
3
4
5
6
7
23. Particulars regarding Specialized Scout/Guide course organized at National/State/All Indian Railway level :
Sl. Event Certificate No. Date of Issue Issued by
No.
1
2
3
4
5
“I hereby declare that all the statement made in the application are true, complete and correct to the best of my knowledge and
belief. In the event of any information being false or incorrect or myself being not eligible in terms of eligibility criteria, my
candidature/ appointment is liable to be cancelled/terminated without any notice at any stage even after empanelment”.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
26. Place:
27. Date: 28. Applicant’s full signature in running script (in Hindi or English)
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APPLICATION FORM : E.N.No. ECoR /Pers/S&G/2023-24 dated 01.02.2024 Annexure-III
Certificate No ………………………….
CERTIFICATE OF ACTIVENESS
Date:
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