ICAR-NATIONAL INSTITUTE OF RESEARCH ON JUTE & ALLIED FIBRE TECHNOLOGY
(Indian Council of Agricultural Research)
12, REGENT PARK, KOLKATA - 700040
Advertisement no. 1/2016/ICAR-NIRJAFT
APPLICATION FOR THE POST OF
_
Important Notes: (i) Before filling this form, read detailed advertisement carefully. (ii) All entries should be made in capital letters.
1. Name (in capital letters) (for S. No. 1 & 2 please keep one box blank between first name, middle name & last name)
2. Father's Name (in capital letters)
3. Date of Birth
4. Age as on closing date
5.
Whether claiming age relaxation ?
Write: Yes/No
DAY
MONTH
Gender
6.
[ Please ‘’ ]
Male
YEAR
YEAR
Marital Status
[ Please ‘’ ]
7.
Female
Married
MONTH
DAY
Nationality
8.
Religion
9.
Unmarried
10. Category (write, as applicable. Attach attested copies of certificate in support of the claim)
CATEGORY belongs to
SC/ST/OBC/Unreserved
If Physically Handicapped
10(a).
(OH/VH/HH)
10(b).
Whether belongs to
Ex-servicemen (Yes/No)
Nature & Percentage of disability
11. Permanent Address (in capital letters)
Name
:
Address
:
Please affix one recent
passport size Photograph
to be attested by
Gazetted Officer
:
City
:
State
:
Pin Code:
Mobile No.
Tele. No (with STD Code):
E-mail Address:


12. Educational Qualification (Matric onwards).
Sl.
No.
Examination passed
Board/University/
Institution
Year of
passing
Subjects/Discipline
% of marks
obtained/
Division
13. Medium of Typing/SkillTest:
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14. Address for correspondence (in capital letters)
Name :
City
:
State
:
Pin Code:
15. Experience (attached attested copies of employer’s certificate in support of claim)
Name of the
employer
Designation
Pay scale/ salary/
consolidated
remuneration
drawn
Period
From
Nature of duties/ works
To
16. Details of application fee:
Demand Draft No.
Date
Issuing Bank
Amount (in Rupees)
17. Whether any of your relative is employed in ICAR-NIRJAFT/ any other ICAR institutes/ ICAR Hqrs. (if yes, furnish the
name/ designation, place of the posting and relationship):
Name of relative(s)
Designation
Place of posting
Relation with applicant
Remarks (if any)
DECLARATION TO BE SIGNED BY THE APPLICANT
I,
do hereby declare that all the 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
particular information given above being
found false or incorrect,
my candidature
for the post
of
_ is liable to be rejected or cancelled and in the event of any mis-statement or
discrepancy in the particulars being detected after my appointment, my services are liable to be terminated forthwith
without any notice to me. I am willing to serve anywhere in India.
Place:
Date:
(Signature of the Applicant)
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