MANIPUR PUBLIC SERVICE COMMISSION

2(two)
APPLICATION FORM passport size
photos 1(one) to
Manipur Civil Services Combined Competitive be pasted and
(Preliminary) Examination, 2008. 3(three) stamp
size photos to
(Every column of this form is to be filled in by the candidate’s
be attached
own hand writing with ink or ball pen)

For office use only

SL. NO……………

1. Details of Fee Payable:-Rs.200/-(Gen & OBC) and Rs.50 (SC/ST) ( in cash only)

2. Full Name (IN CAPITAL LETTERS):-Dr/Ms/Mr.…………………………………………………

…………………………………………………………………………………………………………..........

3. Father’s Name in full:…………………………………………………………………………………....

4. Address:-
(i)Permanent home address in full:--…………………………………………………………………….

…………………………………………………………… P.O. & P.S. …………………………...….

District ……………..…… State…………………………

(ii)Present postal address in full:- :--………………………………………………………………….…

…………………………………………………………… P.O. & P.S. …………………...………….

District ……………..…… State…………………………

D D M M Y Y
5. Date of birth:- (i)

(ii) In Words(…………………………………………………………………………………………...)
6. Age ( As on 1st of July. 2008):-………… years ……….……… months ….………… days
(As per HSLC or Equivalent Examination)

7. Community:- (Gen/SC/ST/OBC)

If OBC : Meitei/Meetei or Meitei Pangal

(SC/ST/OBC candidates to furnish necessary documents in attested copies )

8. Optional Subject:-
(Indicate only one optional subject
for this preliminary examination in
CAPITAL LETTERS)
9. No. of previous appearance in the MCSCC Examination (Preliminary/ Main) by the candidate. :……
10. Qualification(Degree onwards):-
11. Present occupation, if any:-
12. Have you informed your employer/Controlling Authority
of your candidature in writing ?

DECLARATION

I hereby declare that all the statements made in this application are true and complete to the best of my
knowledge and belief .In the event of any information being found false or incorrect before or after the
examination, action may be taken against me by the Commission as deemed fit.

Place: Signature of Candidate.

Date: