Application Form for Recruitment of Ex. Servicemen
BASIC DETAILS
1.Post Applied For
*
:
Senior Manager(Administation)
Officer(Administation)
Junior Technical Assistant IV (Fire & Safety)
2.Post Code
*
:
CPCL 01
CPCL 02
CPCL 03
3.Name of the Candidate
*
:
4.Father’s / Husband’s Name
*
:
5.Date of Birth
*
:
6.Age as on 01.12.2022:
7.Nationality
*
:
8.State of Domicile (state belongs to)
*
:
9.Category
*
:
GENERAL
SC
ST
OBC-Non creamy layer
EWS
10.Do you belong to PwBD category
*
:
Yes
No
11.In case PwBD, indicate the degree of Disability(%):
12.Type of Disability (OH/HH/VH/Multiple Disability) :
OH
HH
VH
Multiple Disability
13.Do you belong to Ex-servicemen category
*
:
Yes
No
14.Gender
*
:
Male
Female
15.Complete Correspondence Address
*
:
District
*
State
*
:
Pincode
*
EDUCATION DETAILS
16.Qualification (Secondary School onwards-mention the exact date of passing)
*
:
Name of Exam.Passed
Name of Institute /University
Name of course
Duration of Course
Date of Admission
Date of Passing
# Percentage
CLASS X
1
2
3
4
5
CLASS XII
1
2
3
4
5
GRADUATION
1
2
3
4
5
POST GRADUATION
1
2
3
4
5
# in case of CGPA / OGPA/SGPA or Grade, mention equivalent percentage of marks as per University / Institute norms. Percentage of marks not to be rounded off.