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APPLICATION FORM FOR THE DEPARTMENTAL PROMOTION EXAMINATION

1. Name of the candidate (in Block letters) ___________________________________

2. Fathers Name (in Block letters) ___________________________________

3. Qualification and BPS ___________________________________

4. Date of birth / Age ___________________________________

5 (a) Full designation and complete postal ___________________________________


address of office.

(b) Total service & date of appointment. ___________________________________

(c) Service in present Rank. ___________________________________

(d) Eligibility of candidate to appear in Yes No


Examination (with reference to service
Limit) if any.

(e) Probationer or Regular ___________________________________

6. Which chance candidate is availing 1st 2nd 3rd

7. Name of Examination in which


candidate wants to appear. __________________________________

8. Date of commencement of Examination. __________________________________

9. Indicate the paper (s) in which candidate wants to appear

PAPER A PAPER-B PAPER-C PAPER-D PAPER-E PAPER-F

10. Certified that I have filled in all the columns completely and no wrong or incomplete information
has been given by me to the best of my knowledge. If anything wrong or incomplete is found, I
shall be liable to disciplinary action under the relevant Efficiency & Discipline Rules.

_______________________________
SIGNATURE OF THE CANDIDATE

NOTE:

- Contract employees are not eligible to apply.


- No exemption in any Paper.
- For compartment 50% of the total papers must be cleared.

(contP/2)
CERTIFICATE BY HEAD OF DEPARTMENT

Certified that ____________________________________________________________

working as _____________________________________________________________

is eligible to appear for the Departmental Promotion Examination from ______________

______________________ in accordance with instructions / minimum Service limit

contained in S.O.P.

___________________________ __________________________
Signature of Head of Department Signature of Controlling Officer

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