Attach passport

size photograph

Application Form
Post: ____________________________________________________________________________
Name: ___________________________________________________________________________
Fathers Name: __________________________ District of Domicile: ______________________
Date of Birth: ____________________________ Age (in figures) :

Years_____Months_____

Preferred District /Department for Placement _________________________________________

Religion: ____________________ Any Disability: ______________________________________
Contact #: _______________________________________________________________________
E-mail: _________________________________________________________________________

Qualification:
Degree

Majors

Division

Date of
Acquisition

Institute/B
oard

Position in
Board

Matric
Intermediate
Graduation
Master
Others
Computer
Knowledge

Work Experience:
(Experience means the post qualification experience gained in a regular full time paid job after obtaining the required
qualifications).

Duration
Organization

Position

Date
From

Date
To

Nature of Experience
Total
Period
(Years)

I______________________________d/s/w of________________________do hereby solemnly affirm

that I have filled the form as per instructions given above and in the event any information contained
herein is found to be untrue, I shall be liable to disciplinary action.

Candidates Signature: _____________________

Dated__________________

Name, Postal Address and Contact

Number

Name, Postal Address and Contact

Number

Candidates Signature: _____________________