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CANDIDATE NAME
(FIRST NAME) (MIDDLE NAME) (LAST NAME)
DATE OF BIRTH (DD-MM-YYYY) GENDER (M/F)
CONTACT PH. NO. (With STD) CONTACT MOBILE NO.
ADDRESS
DIP INSTITUTE
XTH STANDARD (%) YEAR OF PASSING XIITH STANDARD (%) YEAR OF PASSING
DIP SEMESTERWISE
1ST SEM 2ND SEM 3RD SEM 4TH SEM 5th SEM
BREAK-UP
DIP PERCENTAGE
SEMESTER WISE
BACK LOG SEMESTER
BACK LOG (Y/N)
WISE BREAK UP (Y/N)
DIP PERCENTAGE (%) [ As on date]
DIP STREAM
DIP UNIVERSITY
Declarations:
I hereby declare that the foregoing information are correct and complete to the best of my knowledge and belief and nothing has been concealed. If at any time, i
am found to have concealed any material information or given any false details about myself, i understand that my appointment shall be liable to summary
termination without any notice or compensation thereof to me.
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Signature of the candidate: Date:
Instructions:
Candidates are requested to make 2 copies of the “Candidate Information Form & Hall
Ticket” and complete both the copies with all relevant details & photograph. Official Seal & Signature Of Authority Verifying the
Please submit one copy of this form duly filled in during the registration process. The other Information above On behalf of the institute
copy of Hall Ticket will be collected during the written test or interview process
None will be allowed to enter the premises without the 2 copies of this form duly filled in &
photograph duly signed in both the copies.
Candidates are requested to carry the Valid Identification/College ID (which has
photograph) for Identity proof. Please note that failure to bring the identification with
photograph & the form duly filled in would disqualify them from appearing for the selection
process. Signature Of The Authority on behalf of the
institute with seal, name & designation
Please read the company profile, vacancy details & instructions thoroughly in the next
pages.
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