Professional Documents
Culture Documents
Application Proforma For Engagement of Non Faculty Posts JIPMER II Karaikal Puducherry Updated 01.06.2016
Application Proforma For Engagement of Non Faculty Posts JIPMER II Karaikal Puducherry Updated 01.06.2016
at Jawaharlal
Affix
Passport Size
Photograph
Attested by a
Gazetted
Fathers name
: D D M M Y Y Y Y
Sex
Nationality
Religion
Address for communication including Pin code, in caps with Telephone No:, if any
Age
Officer
Male / Female
UR
OBC
SC
ST
Ph. No.:
9
10
11
Office Address
Post held
Subjects
From
Marks
Obtained
To
Year of
Passing
No. of years
and months
(Experience)
Whether
Regular / Temporary
1
2
3
12
13
Yes
No
Declaration
I
hereby declare that all the statements made in this application
are true, complete and correct to the best of my knowledge and belief. In the event of any information being
found false or incorrect or ineligible and detected before or after exam/Interview, I hereby convey my consent for
cancellation of my candidature.
Place :
Date :
Signature____________________________
District Magistrate/Dy. Commissioner etc.