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Notification Coal-Eng2016636045380801159674
Notification Coal-Eng2016636045380801159674
Notification Coal-Eng2016636045380801159674
Note: Candidates are required to mention the scheme (ii) Mobile phones, pagers or any other
and name and number of paper(s) he wishes to appear communication devices are not allowed inside the
in. Application forms should specifically be obtained premises where the examination is being
either from the office of THE DIRECTOR OF MINES conducted. Any infringement shall entail
SAFETY (EXAMS), & SECRETARY, BOARD OF disciplinary action including cancellation of
MINING EXAMINATIONS, DIRECTORATE GENERAL candidature and debarment for three years from
OF MINES SAFETY, DHANBAD-826001 future examinations conducted by the Board of
(JHARKHAND) by sending a self-addressed envelope Mining Examinations.
(size 22 cm x 10 cm) or can be down loaded from the
website www.dgms.gov.in .
dk;kZy; mi;ksx gsrq (For
office use only) ;gka 3-5 ls-eh- x 3-5
izkIr :- Received Rs. ___ ls-eh- vfHkizekf.kr
Mk;jh la- Dy.No._______ QksVks fpidk;sa
Affix attested
fnukad Dated__________ THE MINES ACT, 1952/[kku vf/kfu;e] 1952 photograph
APPLICATION FORM FOR COMPETENCY EXAMINATIONS (3.5 cm x3.5 cm)
Signature UNDER THE CMR 1957 FOR THE YEAR 2016 here.
o’kZ 2016 ds fy, dks;yk [kku fofu;ekoyh 1957 ds v/khu l{kerk ijh{kk ds fy, vkosnu izi=
1 ijh{kk dksM ijh{kk ;kstuk fo’k;
Exam code Name of examination:____________________ Scheme:___________ Subjects____________
2. foxr o’kZ dk ijh{kk dksM 2A foxr o’kZ dk vkbZ-Mh-u-] jksy u- o o’kZ
Prev. Yr’s Exam Code Prev.Yr’s ID No, Roll No & Year
3. vkosnd dk miuke Applicant surname :
4. vkosnd dk izFke ,oa f}rh; uke (fy[kkoV ds cM+s v{kjksa esa) First & Second Name (In Capital Letters)
PIN
Mobile No. E-mail
32.Permanent Address: (LFkk;h irk)
VILL POST
PS DIST
STATE PIN
33. DETAILS OF EXPERIENCE & SERVICE : vuqHko vkSj lsok dk foLr`r fooj.k
Particulars of
Name of the mine & owner Place of experience From To YY/MM/DD
[kku ,oa ekfyd dk uke vuqHko dk LFkku experience ls rd o’kZ@ekg@fnu
vuqHko ds izdkj
3. 4. 5.
35. Lo&?kks’k.kk (SELF DECLARATION):eSa lR; fu’Bk ls ?kksf’kr djrk gwa fd mijksDr fooj.k ,oa lwpuk,a lR; gSa A
I solemnly declare that the above statements and information are true.