Application for the post of ______________________________________________________________

BIO-DATA
01. Name of the Candidate : ……………………………………………
(IN Block Letters)
02. Father’s/Husband’s Name : ………………………………………….. Space for
03. Permanent Address : …………………………………………. Photograph
: ………………………………………….
04. Present Address : …………………………………………..
: ………………………………………….
05. E-mail Address/ Telephone No. : ……………………………………………………….
06. Nationality : ……………………………………………………….
07. Language Known : ……………………………………………………….
08. Date of Birth : ……………………………………………………….
09. Sex (Male/Female) : ……………………………………………………….
10. Marital Status (Married/Unmarried) : ……………………………………………………….
11. Category (SC/ST/OBC/SEBC) : ……………………………………………………….
12. Educational Qualification : ……………………………………………………….
Level of Exam Board/University Year of Division/ Full Marks Marks Secured % of
Examination Passed Passing Grade (including extra Marks
optional)

H.S.C.
C.H.S.E.
Graduation
Post Graduation
M. Phill/ Ph. D
B. Ed (Special
Education)

13. Technical Qualification : ……………………………………………………….

14. Working Experience : ……………………………………………………….
Designation Nature of Name of the Type of Organization Period of Service
work Organization (Govt./Project/Private/
NGO) From To Completed
Years

DECLARATION
I hereby declare that all the above statements are true to the best of my knowledge and belief.

Date :
Place : Full Signature of the Candidate