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APPLICATION FORM H61
1. Position Applied For Senior Counsellors
PHOTO

2. Name:

3. Father'sName

(Married Candidates also need to mention father's name only)


4. Cateegory:
GEN/EBC

5. Date of Birth

6. Aadhar Number

7. Permanent Address:

8. Address For Correspondence:

9. E-mail:
(Should be valid till the recruitment Process)

10. Mobile No

11. Alternate Mobile No:


12. Education Qualification:

Degree Certificate Subjects College Year Of Passing Division/Marks


Institute/
University
Matriculation/10th
Intermediate/12th
Graduation

Post Graduate
Any other
Certification
Please Mention
13. Experience (reverse chronological order-latest first):
46
SN Name of Designation Tenure Responsibility/Assignment | Achievement
Organization

14. Language Proficiency: Understand


Read Write
Language
English
Hindi
Any other, please specify

Beginner/lntermediate/Proficient/Expert
15. Computer Proficiency

Information that the Applicant may


like to add (may use separate sheet ifrequired)
16. Any other Relevant

is true and correct to the best


that the information given in this application false
I do hereby declare în this application proves to be
knowledge and belief. In case any infornalion given even my
of my for the consequences or

or incorrect at any point


of time. I shall be responsible the exam/interviews
that mere appearing for
candidature may be rejected.
I am also àware

for appointnient to the post applied


by me .

does not mean that I am eligible

Signature
Name

Date:

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