North Eastern Development Finance Corporation Ltd. NEDFi House; G.S.

Road; Guwahati 781006; Phone (0361) 222 2200 (30 channels) Fax (0361) 223 7733, 223 7734. Website: www.nedfi.com

Application for the post of .

Passport PHOTO

Name Fathers/ Husbands Name Date of Birth (DD/MM/YY) Present Address

: .. : .. : .. : .. ...

Permanent Address

: .. ...

email / Mobile No. Gender Category (General/ST/SC/OBC

: .. : (Male / Female) Marital status .. (if OBC please mention whether creamy layer or not) If yes, please state the community If yes, please state whether OH /VH /HI & Percentage of disability If yes, please state the period of continuous service in the Armed Forces

Whether you belong Minority Community?

to Yes/ No

Whether you are a person Yes/ No with disability ? Whether you are an ex- Yes/ No servicemen ?

Academic Qualifications starting from class-X onwards: Sl. No. Examination Passed Institution /Board/University Year % of Marks obtained Division/Class

Work Experience (starting from current job): Name of organization Post Held Period Nature of duty Last salary drawn

Languages known: i) ii) iii) .. ..

Read

Write

Speak

Scholarships or Awards Extra Curricular activities

: : .

Name and Address of two referees (not related to candidates): 1 . 2 .

Any other relevant information

: .

Indicate choice for group discussion and written test centre (Mark x in appropriate box) New Delhi Kolkata Guwahati

Details of Demand Draft (DD): DD No. Date Amount Name of Issuing Bank

Place : Date : Signature