Microsoft Word - Application Form Identity certificate.docx
(2 )
:05.08.2018
:04.09.2018
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15. : , i.___________________________________
ii. __________________________________
iii. _________________________________
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ii. _________________________________
iii. ________________________________ ( )
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APPLICATION FORM
(2 Nos. Self Attestedpassport size photograph )Date of publication:05.08.2018
Closing date for submission of applications:04.09.2018
Post Applied for :
1. Name:
2. Fathers Name:
3. Address:
:
: __________________________________________
4. Date of Birth : 5. Sex : Male :Female :
6. Nationality : _____________________ 7. Domicile: ______________________
8. Religion : ______________________ 9. Category : _____________________
(Page 2)
10. E-mail ID: _______________
11. Telephone No. (With Std Code):_______________
12. Mobile No. (If any): _________________
13. Educational Qualification :
Qualification
Subjects
Percentage of marks
Year of Passing
Institution
University
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14. Experience :
Name of the Organization
Designation
Period
Nature of duties
From
To
15. Books published : If yes, give details i.___________________________________
ii. __________________________________
iii. _________________________________
16. Paper published : If yes, give details i.__________________________________
ii. _________________________________
iii. ________________________________ (Attach detail)
17. Knowledge of GIS :
GIS Certification
Certificate/Diploma/PG Diploma/Advance Course/Degree or any other (any one)
GIS Tools
ArcGIS/any other Software ______________________
Level of expertise
Basic/Intermediate/Expert (any one)
Declaration : I hereby declare that all statements made in the application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found untrue / false / incorrect or I do not satisfy the eligibility criteria, my candidature / appointment will be cancelled / terminated, without assigning any reasons thereof. I have read the contents of the advertisement and agree to abide by the rules, regulations and procedures for appointment to the post applied for.
Date :
Place : (Signature of Applicant)
Note:- Please self attest all the documents.