APPLICATION FOR THE POST OFIN 5033 ASC Bn (CIV GT)
1. Post applied for
2. Name (In block letters)
3. Father’s Name
4. Date of Birth (Att. copy of birth certificate duly attested)
5. Age as on last date prescribed for receipt of application Years Months Days
6. Address for correspondence with Tele No :
House No./Street/Village Post Office Tehsil Distt State PIN Code
7. Permanent Address
House No./Street/Village Post Office TehsilDistt State PIN Code
8. Caste : Gen/OBC/SC/ST (Attach certificate in case of SC/OBC)
9. Educational qualifications (Attach education Certificate duly attested)
10. Any other qualification/Experience (Attach copy of experience certificate duly attested)
11. Category for which applied : Gen/OBC/SC/ST/etc (Attach copy duly attested)
12. Technical Training/Experience (Attach copy duly attested)
13. Domicile : (Attached copy duly attested)
14. Whether registered with any Employment Exchange :- Yes/No : if yes, mentioned
Registration No. and Name of Employment Exchange :
I do hereby declare that all particulars furnished by me above are correct and true to bestof my knowledge and belief. I understand that in the event of any particulars or informationgiven by me found false or incorrect at any stage, my candidature is liable to be rejectedor cancelled at any stage.
Affix recent
passport size
photograph
(Computer
photo not
accepted)
Dated :
(Signature of the candidate with date)
FOR OFFICIAL RECORD ONLY
Affix recent
passport size
photograph
(Computer
photo not
accepted)
1. Received on
2. Accepted/Rejected
3. Reason for rejection : Underage/overage/incomplete documents/Any other reasons to be specified
4. Index No. Date of Test/Practical/Physical test
Signature of Bd of Offr’s
(TO BE SUBMITTED ALONGWITH APPLICATION)
ADMIT CARD
Admit Card No./Roll No. :
1. Name of candidate
2. Father’ Name :
3. Address for correspondence:
House No./Street/Village Post Office Tehsil Distt State PIN Code
4. Date and time of Written /Practical/Physical Test
5. Venue of Exam
(Signature of Issuing Officer with stamp)