ANNEXURE-I APPLICATION FORM

Application for the Post of - ___________________________

(Please read the instructions carefully before filing the Form)

AFFIX PASSPORT SIZE PHOTO DULY SIGNED

1 2

Name in Full Date of Birth

(DD/MM/YYYY)

Age as on 01.06.2012 :

Category (retain / ( the one applicable)

) SC / ST / OBC / PWD / EX SERVICEMEN / J&K DOMICILED / VICTIM OF RIOTS OF 1984/ GENERAL

Religion Address for Correspondence with Pin Code Nearest Railway Station Telephone No/Mobile Tel.no. Mob. No.

Permanent Address Domicile state Telephone No

E-mail

7. QUALIFICATIONS (starting from SSC)

Sl. No.

Qual.

Branch

University / Board

Duration of the course

Whether Govt. recognized College / Univ. recognized by UGC

Whether regular and full time (Yes / No)

Year Passing

of

% of Marks

Year of passing Boiler proficiency Certificate:________________________________________

7.1. 7.2. Please mention aggregate Percentage of marks for Graduation (last 4 semesters) / (last year) as applicable: Please mention aggregate Percentage of marks for PostGraduation (final year /last two semesters) as applicable:

8. ARTICLES, IF ANY, PUBLISHED:

9. DETAILS OF EXPERIENCE: (Starting from Present Position (including Training / Internship))

Sl. No. Name of the Organization Design. From (please mentioned exact date) To (please mention exact date) Total experience (years, months, days) Employer Whether Private/ Govt./PSU Total Emoluments (Gross) Per Month Please mention experience (Trainee/ Regular)

Note Please attach a separate sheet narrating the details of jobs and responsibilities handled if required.

10. TOTAL EXPERIENCE (except for the post of Officer HR):

TOTAL PERIOD UNDERGONE TRAINING AFTER ACQUIRING MINIMUM REQURED PRESCRIBED QUALIFICATION TOTAL EXPERIENCE AFTER ACQUIRING MUMIMUM REQUIRED PRESCRIBED QUALIFICATION (TRAINING + REGULAR) TOTAL EXPERIENCE AFTER ACQUIRING MINIMUM REQURED PRESCRIBED QUALIFICATION PRESENT PAY SCALE/GROSS PAY Pay Scale:__________________________________ Rs. PRESENT DESIGNATION DATE OF ENTRY IN THE PRESENT PAY SCALE :_______________________Per Month YEARS MONTHS DAYS

11. TOTAL EXPERIENCE (FOR THE POST OF OFFICER HR):

YEARS TOTAL EXPERIENCE MONTHS DAYS

12. HAVE YOU EVER BEEN CONVICTED BY ANY COURT OF LAW OR ANY YES/NO DISCIPLINARY PROCEEDING / ENQUIRY IS PENDING AGAINST YOU OR ANY PENALTY HAS BEEN IMPOSED UPON YOU? IF YES, GIVE DETAILS. HAVE YOU EVER FACED ANY EXTRADITION / DEPORTATION YES/NO PROCEEDINGS? IF YES, GIVE DETAILS

13. JOINING TIME HOW SOON CAN YOU OFFERED APPOINTMENT

JOIN

IF

14. DD DETAILS DD DETAILS (applicable for General Name of the Bank DD Number-DD Date and OBC candidates) Amounts(Rs.)-

15. WHETHER APPLIED FOR ANY POST IN RCF EARLIER : IF YES, DATE/MONTH OF APPLICATION POST APPLIED FOR

YES/NO

I state that all the information given above is true and correct. In case any of the details given above turnout to be false I will make myself liable to lose the candidature.

Date:

_______________________ Signature of the Candidate

Place:

INSTRUCTIONS

1. 2. 3.

AFFIX PASSPORT SIZE PHOTO DULY SIGNED. FILL THE FORM IN CAPITAL LETTERS ONLY. GIVE THE TRUE, COMPLETE AND CORRECT INFORMATION IN THE APPLICATION FORM. IN CASE THE INFORMATION IS FOUND TO BE FALSE OR INCORRECT, THE CANDIDATE WILL NOT BE CONSIDERED FOR INTERVIEW. ENCLOSE ATTESTED COPIES OF CERTIFICATES / DOCUMENTS IN SUPPORT OF INFORMATION GIVEN IN THE APPLICATION REGARDING AGE, QUALIFICATIONS, EXPERIENCE, CATEGORY / CASTE (IF APPLICABLE), CERTIFICATE FROM COMPETENT AUTHORITY REGARDING J&K DOMICILED (IF APPLICABLE) AND VICTIM OF RIOTS OF 1984 (IF APPLICABLE) ETC. ENCLOSE DD FOR RS. 500/- ( IF APPLICABLE) SEND THE APPLICATION IN AN ENVELOPE SUPER-SCRIBING "NAME OF THE POST APPLIED FOR" IMPORTANT (a) ENSURE IN YOUR OWN INTEREST THAT YOU FULFILL THE ELIGIBILITY CRITERIA. (b) RAIL/ROAD FARE SHALL NOT BE REIMBURSED TO OUTSTATION CANDIDATES NOT ELIGIBLE FOR INTERVIEW AND ALSO TO CANDIDATES NOT HAVING PROPER TICKET. (c) IN SUPPORT OF EXPERIENCE YOU ARE REQUIRED TO ATTACH SERVICE CERTIFICATE, APPOINTMENT LETTER, RELIEVING LETTER, ETC. *****

4.

5. 6. 7.