Académique Documents
Professionnel Documents
Culture Documents
(CIPET)
Affix PP size
colour photo
2. Full Name
(in block letters)
4. Community
(SC/ST/OBC/GEN) AADHAR NO.
8. Nationality Religion
9. Mother tongue
10. (a) Details of Mother & Father
Father Mother
Name: Name:
Occupation: Occupation:
B)
WEBSITE:
15. Have you ever faced any Vigilance Enquiry or enquiry by anti-corruption bureau/Central
Bureau of Investigation or any other Investigative Organization
Yes No
If Yes: Please indicate in brief, the details of the Vigilance Enquiry and outcome thereof
in separate page
(Please attach photocopies of Degree Certificates including Date of Birth proof only.
Copies of semester-wise mark sheets need not be attached)
Give particulars in a chronological order starting with SSLC (Xth Std) School Certificate
Duration
Mode of
Name of of
study Pass
Name of the Degree /
Full Division
Course / Institution Subject/ % of Marks/ PG
Sl. Time / (Ist or Year of
Degree / Specializat CGPA (whether
No. Part time IInd or Passing
University ion 1 yr. or
/ IIIrd)
/ Board 2 yrs. or
Correspo Class
3 yrs.
ndence
course
5
17. Employment details: (Give particulars in ascending chronological order starting from the
first employment Mention Post Qualification experience only)
Period of
Position Pay Scale Place / State
Sl. Organization Name / Employment
held / & Gross of
No. Employer (Month/Year)
Designation Salary Employment
From To
1.
2.
19. If you claim work Experience in the relevant area of requirement, please furnish clear
details below:
Area of Experience:
Tool Room /Design/CAD CAM Processing/ Testing
_____________________________________
20. Any other information which you would wish to disclose / highlight with reference to the
relevant job requirements :
21. Reference
Responsible persons not related to the applicant but closely acquainted with the applicant
Phone:
Email:
Phone:
Email:
D.A./I.D.A. Rs.
H.R.A. Rs.
25. Social / Political / Religious Affiliations of the Candidate if any, Mention the name and
clear details about the affiliations:
(i)
(ii)
(iii)
(iv)
(v)
(vi)
DECLARATION
I declare that the Entries made in the Columns of this proforma are correct and true to the
best of my knowledge and nothing has been either concealed or misrepresented by me. In
case of any misrepresentation, I understand that employment if any gained, is liable for
termination.
Place: Signature
Date:
---------------------------------------------------------------------------------------------------------------------------
Date: ________
The applicant has been working in this Office / Organization / Institute / University as
have No Objection to his/her candidature being considered for the post he / she is applying.
Place:
Signature
(Name & Designation with
seal)
N.B.: 1). Use separate sheets wherever necessary while filling application form above.
2). All entries in this application form shall be neatly typed.