9/20/2014 Welcome to HARYANA POLICE RECRUITMENT BOARD, Bays No 31 - 32 Sector - 4, Panchkula

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Online Application Form
Post Details
Advertisement Number : Advertisement No. 3/2014
Post Code / Post Name : 1 / WATER CARRIER IN HARYANA POLICE
Personal Details (as per matriculation certificate)
Candidate Name * : * As per certificate
Father's Name * : * As per certificate
Mother's Name * : * As per certificate
Date of Birth * : Date Month Year * As per certificate
Age on eligibility date (26/09/2014) * : Years Months Days
Visible Identitification Mark * :
Gender * : Male Female
Whether you can read and write in Hindi or passed Matric with Hindi? * : Yes No
Email ID * :
Confirm Email ID * :
Mobile No * :
Nationality of the Candidate * : Indian Others
Candidate's Home State * : Select State
Candidate's Home District * :
Bank Name for E-CHALLAN (applicable if fee is payable) * : State Bank of Patiala
Correspondence Address
Address 1 * :
Address 2 :
Address 3 :
State * : Select State
District /City * :
Pin Code :
Permanent Address
Same as above
Address 1 * :
Address 2 :
9/20/2014 Welcome to HARYANA POLICE RECRUITMENT BOARD, Bays No 31 - 32 Sector - 4, Panchkula
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Address 3 :
State * : Select State
District /City * :
Pin Code :
Other Details
Are you domicile of Haryana * : Yes No
Category * :
Gen SC BCA BCB SBC EBPG
ESM DESM DFF OSP
Criminal Proceedings detail. If any
(a). Whether any Criminal case(s) has been registered against you
and were you arrested?
Yes No
(b). Have you ever been convicted by Court of law in any criminal
case?
Yes No
(C). Whether any criminal case(s) is pending against you in any court
of Law or with police, at present?
Yes No
If. the answer to any of the above mentioned questions is Yes, then
give full particulars of the case FIR NO. and date, Sections of offence,
Police Station, District and status of the case at the time of filling up
this application form.

(Note :- If it ever comes to the notice that the candidate has furnished false information or has suppressed any factual Information his candidature shall
be rejected)
Education qualification
Educational Qualifications
Year of
Passing
Marks Obtained Total Marks % age Division
Name of School /
Board / University
(Maximum 15
Characters)
Subjects
5th Class Year NA NA NA NA NA
8th Class Year NA NA NA NA NA
9th Class Year NA NA NA NA NA
10th Class Year Select Select
ITI Year Select Select
Name of Educational institution (School/College/University) last attended * :
Experience
Sno. Experience As From Date To Date Duration Organization Name
1. Select Years Months Days
2. Select Years Months Days
3. Select Years Months Days
4. Select Years Months Days
5. Select Years Months Days
Upload Photo & Signature
9/20/2014 Welcome to HARYANA POLICE RECRUITMENT BOARD, Bays No 31 - 32 Sector - 4, Panchkula
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(Upload Recent colored photo ,
Photo Size Maximum 200 px X 200 px
and Photo format is JPG/GIF only)
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(Upload Signature Size Maximum
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is JPG/GIF only)
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DECLARATION
I) I hereby declare that the statements made in this application are true and complete to the best of my knowledge and belief. In the event of
any information being found false or incorrect, or ineligibility being detected before or after the test and interview, my candidature will stand
cancelled and all my claims for the recruitment will stand forfeited.
II) That I have read the provision in the advertisement carefully and I hereby undertake to abide by them, I fulfill all the conditions of eligibility
regarding age and educational qualification prescribed In the advertisement.
I Accept.
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