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Application Form Application Number Token Number 1. Exam Details 1.1 Examination 1.2 Post 1.

3 District Head Quarter for 1.4 General Subjects (PRE) 1.5 Optional Subjects (PRE) 1.6 General Subjects (MAINS) 1.7 Optional Subjects (MAINS) 1.8 Number Of Attempts 2. Department Preferences 2.1 Department Preference 3. Applicant's Details : 3.1 Applicant's Full Name 3.2 Applicant's Father Full Name : 3.3 Applicant's Mother Maiden Name : 3.4 Date Of Birth (dd/mm/yyyy) : 3.5 Gender : 3.6 Marital Status : : 3.7 Category : 3.8 Home State (Bonafide 3.9 Home District : Dilip Gurjar Kamal Singh Rajanti 26/02/1990 MALE Unmarried BC (Non Creamy Layer) RAJASTHAN DAUSA Photo & Signature Of Candidate 4. Other Special Categories 4.1 Category for Disabled 4.2 Specific Category for Female 4.3 Other Category 5. Correspondence Details 5.1 Address : : : : 1 - PANCHAYATI RAJ DEPT , 2 - WATER RESOURCE DEPT , 3 - PHED : 001110101868322 : 1300011100010628 : : : : ASSISTANT ENGINEER CIVIL EXAM 2013 ASSISTANT ENGINEER CIVIL JAIPUR Gen Science ,GK with Ref. to Rajasthan Application Filled Date Reference Application : 29/03/2013 6:44 PM : 001110101868322

: CIVIL ENGINEERING : HINDI | SOCIAL ASPECTS OF ENGINEERING : CIVIL ENGINEERING : 0

: RZ 6/239 P-BLOCK WEST SAGAR PUR ,NEAR DAYAL PARK NEW DELHI-46, WEST SAGAR PUR,Tehsil : NEW DELHI,City/Village : NEW DELHI - 110046 Dist : NAJAFGARH, State : DELHI : cutestluvguy@gmail.com : : 9873245603
Year Division/Grade

5.2 Email 5.3 Phone 5.4 Mobile 6. Qualification

6.1 Secondary : 2006 6.2 Sr. Secondary : 2008 6.3 Graduation : 2013 6.4 Post Graduation : 7. Additional Qualifications/Specifications 7.1 Other 7.2 Examination passed 7.3 Internship Period 7.4 Experience 8. Identification 8.1 Body Mark : : : From : : Year : : Mark on left eye

first first Appearing

To : Months : Days :

9. Disclaimer I hereby declare that all information made in this application are true, complete and correct to the best of my knowledge and belief. In the event of my information being found false or incorrect or the ineligibility being detected before or after the Screening Test/Interview, action can be taken against me by the Commission. I have read the provisions of the relevant rules and the Advertisement carefully and I hereby undertake to abide by them. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualification and required experience etc. prescribed for admission to the Screening Test/Interview. Also I accept SMS facility provided by the Commission.

Rajasthan Public Service Commission Ghooghara Ghati, Jaipur Road, Ajmer Phone : +91+145+ 5151200, 5151240 & 5151090

Nodal Officer: Mr. Akhilesh Mittal,System Analyst(0145-5151212)

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