Online Registration

Fill Online Registration Form

Name of Post (Apply For)

1. Full Name (In Capital Letter)

2. Father's/Husband's Name

3. Gender

Male Female

4. Category

GEN OBC SC ST

5. Date of Birth

6. Nationality

7. Do you claim any age relaxation ? Tick (Yes or No.) , if Yes then Why ? Yes No

8. Local address with pin code

9. Permanent address with pin code, if same as local address then Tick

10. Enter 10 Digit Mobile No.

11. Email Id

12. Educational/ Professional Qualification

S.No.	Class/Course	Board/University	Year of Passing	Percentage	Dividsion/Grade
1.
2.
3.
4.

13. Details of previous experience: (Current job first)

14. Any other relevant information you wish to add related to field work experience.

15. Upload Your Photo (Only .jpg file are allow)

16. Enclosures : Tick the below list as per your qualification & certificate availability.

1.	Date of Birth Certificate (School Leaving Certificate)	Yes No	(Optional)
2.	Caste/ Category Certificate	Yes No	(Optional)
3.	Class 10th Mark-sheet & Certificate	Yes No	(Optional)
4.	Class 12th Mark-sheet & Certificate	Yes No	(Optional)
5.	Graduation Mark-sheet & Certificate	Yes No	(Optional)
6.	Post Graduation Mark-sheet & Certificate	Yes No	(Optional)
7.	Any others Mark-sheet & Certificate	Yes No	(Optional)

Upload Only single pdf file that contain all above Tick(Yes) document should be upload here.

DECLARATION

I hereby declare that the information furnished above is true, complete and correct to the best of my knowledge and belief. I understand that in the event of my information being found false or incorrect at any stage or any attempt has been made by me to willfully conceal or misrepresent the facts, my candidature/appointment shall be liable to be cancellation/termination without any notice or compensation in lieu there of.

Place :
Date :

Upload Signature (Only .jpg file allow)