Annexure‘ FORMAT OF APPLICATION FORM FOR POSTS OF Employment Notice No Closing date Time 1700 hours (FORM TO BE FILLED IN BLOCK LETTERS IN CANDIDATE’s OWN HANDWRITING) (PLEASE KEEP ONE BLANK BOX IN BETWEEN WORDS) (PLEASE WRITE ONE LETTER ONLY IN ONE BOX) 1. (@)_ Post applied for D'ManSupwr8/S SK-II_ CMD (OG) Peon Chow (Tick on one only) Affix latest passport size Photograph Safaiwala Chow (Kh) Meter Reader Caneman duly pasted and self attested, () SPECIFY COMMAND PREFERENCE FORIIll 1 to 6 in order of preference) —C we NC sc cc swo (>) MATE ONLY () GWE AREA FOR WHICH APPLIED FOR 2. Name of the candidate: FIRST NAME MIDDLE NAME SURNAME 3 Sex (write ‘M' for male and ‘for female in the box) 4 Father's/Husbana’s Name FIRST NAME MIDDLE NAME SURNAME CLTTTTrT rrr rr rrr rr rrr rrr rrr rrr) 5 (@)_ Candidates Date of Bit (In figure) Db MM yw (©) Candiciates Date of Birth (In words) (©) Ageason Years Months. days(@) Whether candidate seeks age relaxation (Write °Y’ for yes and 'N’ for ‘No’. If yes, tick the appropriate boxes under which age relaxation are ‘sought. In case candidate belongs to more than one category the same to be mentioned, also attach necessary certificate in support) sc_][st_] [osc_] [ovorceniseraratenwioow | ‘SPORTS PERSON DEPARTMENTAL, J& KOOMIGILED EX-SERVICEMEN 6. Permanent Address T T 1 7. Address for Communication :- T T 1 8. Qualification as on Matriculation =~ (mention all educational qualifi PHYSICALLY HANDICAPPED OTHERS (SPECIFY) ion starting from Name of Name of Year of Passing | % of Marks Division Examination __| Board/University 9. Please tick appropriate boxes against columns as applicable :- (@) Religion (if other, then please also mention) Hindu/Sikh/Muslim/Christian/Other (b) Nationality INDIAN OTHER sc _|Lst ||_osc || Gen (©) Category to which the candidate belongs (certificate to be attached as per proforma) (d) Whether physically Handicapped (Yes/No) y| LN (yes, disability certificate to be attached as per proforma) (©) Whether Ex-servicemen (Yes/No) Y1 Iw (if yes, undertaking certificate to be attached as per proforma)a ©) oar coneg MES psa) o oes : Sheers OoDECLARATION 1. nae ot somites hr spleen ri eaten am aves at 1 Conravete is mr apo beets soma he Dear 2, nae rad prone 4 Neti axe cry an | Dy nse ey ee EegsysesvescurtamanBccrly nesapsatiotg anaeaed a ‘onderea one pe enon » » © 4a ne sai at tac ms ah agpaon ae 1, amp nd cone tbs my ror ah set rasan tal he ee ‘Siro on mora spss ea ogy tng ance ee ot . 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