Annexure 'C' Paste your photograph here
Name of the Post
Category under which candidate has applied(Tick appropriate)
Marks obtained in written test_____________Roll Number ________________________
Name of the Candidate ____________________ Father's name ___________________
Mother's name _____________________ Date of Birth____________________
Age (as on 07.10.2013) Year _______________Month ____________Days ___________
Sex: Male/ Female
Address for Correspondence Permanent Address
___________________________ ___________________________________
____________________________ ________________________________
____________________________ ____________________________________
Mobile No._____________________________ Email. _________________________________
Do you fulfill the requisite qualification (Yes/ No)
as per the advertisement?
Have you passed Punjabi upto matric level? (Yes/ No)
Educational Qualifications
Whether employed in any other organisation Yes/ No
If yes, whether NOC produced Yes/ No
Have you ever been dismissed from Govt. Yes/ No
Service or have been convicted by any
Court of law?
Detail of documents attached, mark tick .
1. Matriculation Certificate (proof of age)
2. Certificate of Punjabi pass upto matric
3. Graduation
4. Post Graduation
5. Certificate claiming the reservation.
I hereby declare that the above information/detail given by me is true and correct.
Signature of the Candidate
Date:
Place :
Name of the Post
Category under which candidate has applied(Tick appropriate)
| General Category | Scheduled Caste (R & O) | Scheduled Caste (R & O)- Ex.SM | Scheduled Caste (R & O)-Sports | Scheduled Caste (M & B) | Scheduled Caste (M&B) Ex.SM | Scheduled Caste (M & B) Sports | |||||
| Backward Classes | Backward Classes Ex.SM | Ex-Serviceman | Handicapped | Sports person | Freedom Fighter | ||||||
Marks obtained in written test_____________Roll Number ________________________
Name of the Candidate ____________________ Father's name ___________________
Mother's name _____________________ Date of Birth____________________
Age (as on 07.10.2013) Year _______________Month ____________Days ___________
Sex: Male/ Female
Address for Correspondence Permanent Address
___________________________ ___________________________________
____________________________ ________________________________
____________________________ ____________________________________
Mobile No._____________________________ Email. _________________________________
Do you fulfill the requisite qualification (Yes/ No)
as per the advertisement?
Have you passed Punjabi upto matric level? (Yes/ No)
Educational Qualifications
| Examination Passed | Name of Board/University/ Institution | Month & Year of Passing | %age of Marks | Division |
Whether employed in any other organisation Yes/ No
If yes, whether NOC produced Yes/ No
Have you ever been dismissed from Govt. Yes/ No
Service or have been convicted by any
Court of law?
Detail of documents attached, mark tick .
1. Matriculation Certificate (proof of age)
2. Certificate of Punjabi pass upto matric
3. Graduation
4. Post Graduation
5. Certificate claiming the reservation.
I hereby declare that the above information/detail given by me is true and correct.
Signature of the Candidate
Date:
Place :
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