Advt. No.

: BCPL-8/2012

APPLICATION FOR POST OF ________________

Paste your Latest passport size colored photograph

I. POSITION DETAILS Post Pay Scale Grade II. PERSONAL DETAILS 1. 2. 3. 4. 5. 6. First Name Middle Name Last Name Date of Birth Category Name of the Caste/Tribe (In case of SC/ST/OBC) 7. Other Category, If Applicable (i) (ii) (iii) : : : : : : : : : :

Physically Handicapped : Ex-Serviceman Domiciled in J&K : :

between 01.01.80 & 31.12.89 8. Details (In case of PH) (i) (ii) Type of Disability

Percentage of Disability : -:1:-

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Details : (In case of Ex-serviceman) (i) (ii) (iii) (iv) (v) Rank :

Corps/Regiment Number : Date of Commission Date of Discharge Date of start of precommissioning training, if any : : : : : : : : : : : : : : : : : : :

(vi) (vii) 10. 11. 12. 13. 14.

Education of Military Length of service

Nationality Religion Sex Marital Status Present Postal Address (i) (ii) (iii) (iv) (v) (vi) (vii) (vii) C/o House Number City District State Pin code Telephone (Landline) Telephone (Mobile)

15.

E-mail Id.

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III.

EDUCATIONAL DETAILS Branch/ College/ Discipline Institution Year of Joining Year Board / of University Passing % of Type Mark (Full time / Part time / Distance Mode)

Exam Degree Passed

School level Examination Details SSC (10th) SSC (10+2) Higher Qualification Examination Details

IV. PARTICULARS OF POST QUALIFICATION EXPERIENCE [Please provide details of experience starting from present with scale. In case you have served at different positions (on account of promotion in a particular organization, then, please give details of different position held in that organization with dates and scales)]

Indus Comp Employment try / period Name Orgn. From To Type

Post Scale From

Pay Details Scale To Basic Pay

Total Pay P.M.

Functional Details

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V. 1.

CURRENT POSITION DETAILS Mention you position in the hierarchy and the levels above and below you:

2.

Provide a brief write up on why you consider yourself suitable for the post citing your major achievements:

VII.

APPLICATION FEE DETAILS:

Bank Name Branch Name City Date Amount Demand Draft No./ Bankers Check No.

VIII. HAVE YOU APPLIED IN BCPL DURING THE LAST TWO YEARS: IX. DECLARATION I Certify that1. I am employed in Govt./Statutory Organization/Public Sector Undertaking 2. In case of my employment in Govt./Statutory Organization/Public Sector Undertaking, I will produce NOC time of Written Test/Interview

I declared that all information given in this application form are true to the best of my knowledge and belief. If any of the information is found to be incorrect or distorted at any stage, I shall have no objection to cancellation of my candidature.

(Signature) (Name of the Candidate) (Location) Date _________

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