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APPLICATION FORM

1. Post Applied For --------------------------------------------------------------------------------------------2. Advertisement Notice No ------------------------------------------Dated-------------------------------3. Name of the Candidate ------------------------------------------------------------------------------------4. Parentage------------------------------------------------------------------------------------------------------5. Date of Birth---------------------------------------------------------------------------------------------------6. Age as on 01-01-2011---------------------------------------------------------------------------------------7.
Gender-------------------------------------------------------------------------------------------------------------------------------------8. Nationality
------------------------------------------------------------------------------------------------------------------------------------9.
Category---------------------------------------------------------------------------------------------------------------------------------------10. Are You Permanent Resident of J& K
--------------------------------------------------------------------------------------------------11. Name of Block
-------------------------------------------------------------------------------------------------------------------------------12. Name of District
----------------------------------------------------------------------------------------------------------------------------13. Permanent Address
------------------------------------------------------------------------------------------------------------------------14. Address for
Correspondence------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------15. Telephone No/Mobile
No-----------------------------------------------------------------------------------------------------------------16.Details of Qualification
Examination
Passed

Name Of Board
/University

Year Of
Passing

Max
Marks

Marks
Obt.

Percenta
ge

Matric
10+2
Graduation
Post Graduation
M.Phil/Ph.D
MBA
Degree In RD
Diploma In RD
Any Other
15. Experience in Field Of RD (If Any)
------------------------------------------------------------------------------------------------------SIGNATURE OF
APPLICANT

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