Microsoft Word - Application Form Identity certificate.docx

(2 )

:05.08.2018

:04.09.2018

1. :

2. :

3. :

:

: ____________________________________________

4. : 5. : ::

6. : 7. :

8. : 9. :

10. -:

11. . (... ):

12. . (If any):

13.

14. :

15. : , i.___________________________________

ii. __________________________________

iii. _________________________________

16. : , i.__________________________________

ii. _________________________________

iii. ________________________________ ( )

17. ... :

...

/ / / / ( )

... ArcGIS/ ______________________________

/ / ( )

,

:

: ( )

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

14.

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.