Escolar Documentos
Profissional Documentos
Cultura Documentos
1.
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Photo
2.
3.
_________________________________
4.
Mothers Name
Fathers Name
Husbands Name
:
:
[SURNAME]
:
:
[NAME]
______________________________________________
__________________________________________________
__________________________________________
6.
7.
Date of Birth
8.
Whether SC/ST/OBC/PH/General
Married / Unmarried
9.
Marital Status
10.
Educational Qualifications
SR.
NO.
EXAM. PASSED
5.
11.
Work Experience
SR.NO.
PERIOD
GRADE
YEAR
BOARD /
UNIVERSITY
SPECIALIZATION
:
POST HELD &
SCALE OF PAY
REASON FOR
LEAVING
12. Employment Exchange Registration details, [if available]: No: _____ Exchange: ____.
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13. If selected what period would you require joining the post: _____________________.
14. Have you ever been declared unfit by a medical Board/Court _____Yes / No _______. for
appointment in any Govt. Service?
If yes, details ________________.
I hereby declare that the particulars furnished in this form by me are true to the best of
my knowledge and belief and I agree to the terms and conditions of appointment given in
advertisement.
Date: ______________________
Place: _____________________
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