,$t3n
3_,,-
irii-iri
.;N74',
APPLICATION FORM FOR JRF
Af fix
Passport Size
Photograph
l.
2.
3.
4.
5.
Post applied for
Advertisenrent No. & Date
Narne of the candidate
(ln Block letters)
Father/Husband'snante
Date of Birth (in Christian era)
Age in Years, Months & Days
6.
Whether belongs to SC/ST/OBC/UR/pwD/Ex.S.Man
7.
Nationality
8.
Present Postal Address with pin code
For- correspondence
9.
Phone No.
10.
E-mail ID
in block letters
Contd...2
t1.
Educational Qualitications
sl.
Name of
No.
Exanrination
the
( 10tl'
class onwards)
Year of
Name
of
Passing
Board/University
the
tt/o
of Division
Marks
passed
12.
S u
bj ect/Discipli ne tn-
E
gin eeri ng
n
or
Science/Other
Details olEmploynrent (Work Experience), if any.
Name
of
the
Post held
From
To
Olfice/l nstt,/Orgn.
Pay
Band
Nature of Duties
with
Grade Pay
and
Basic
Pay
Total Experience in Years/MonthslDays
I
_1.
Additional infonnation. if any, which you would
like to mentiolr in suppolt of your sr-litability for
the post. E.nclose a separate sheet if the space is
insuffic ient.
Declaration
I affirm that information given in this application is true and correct. I also fully understand tlrat
it is discovered that any attempt has been made by me to conceal rvillfullv or
trisreptescnt the tact(s), nty candidature may summarily be rejected or employrnent terminatecl.
if
at any r.tage
PIace..,....,...........,..
Dale.......................
Signature of the Candidate
ADMIT CARD
Aftlx
Passport Size
Photograplr
I
Nanre
2.
Full Address tbr correspondence
3.
4.
Post applied for
Roll No.
(Sl. No. 4, to be tilled bv Office)
(Signature of Applicant)
ADMIT CARD
Affix
t Size
Photograph
Passpor
.
2.
Name
3.
4,
Post applied
I
Full Address for correspondence
for
Roli No.
(SI. No. 4, to be
lilled by Olfice)
(Signature of Applicant)
Nota:- In case opplicotiotr .fbrm is incomplete or without, photographs, will be reiected summurillt.