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KER
Barcode
ALA
PUB
LIC
SER
VIC
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MIS Category No374/2010
SIO Barcode : S1001914
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APP
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Name of post : JUNIOR OFFICER (COMPUTER) Scale of Pay: Rs. 2215 - 4005/-
Department / Company/ Corporation/Board/local Authority/Co-operative Institution : FOAM MATTINGS (INDIA)
LIMITED Gazette Date : 30/11/2010
1. Name with Initials (IN BLOCK LETTERS) ANZIL K
TC 20/1665,KUNCHALUMOODU
2.(a) Address to which communications are to be TRIVANDRUM, KARAMANA,695002
sent (IN BLOCK LETTERS) anzilkasim@gmail.com
Mobile: 9349515144
TC 20/1665,KUNCHALUMOODU
(b) Permanent Address
TRIVANDRUM, KARAMANA,695002
3.(a) Date of Birth ( In figures and Words) 25/5/1976, TWENTYFIFTH MAY NINETEEN SEVENTY SIX
(b) Sex MALE
4. Are you eligible for communal reservation?
YES
(Yes/No)
5.(a) Religion ISLAM
(b) Community/Caste/tribe with sub-caste MUSLIM,MUSLIM
6.(a) Educational Qualifications B.SC COMPUTER SCIENCE, PGDCA FROM ER DCI, DOEACC A
LEVEL PASSED,(1,)
(b) Experience, if any
 HAVE MORE THAN 3 YEARS EXPERIENCE
7. (a) Name of Mother/Father/Guardian KASIM E,FATHER
(Specify relationship)
(b) Mother Tongue MALAYALAM
8. (a) Nationality
INDIAN
(b) State, District and Taluk to which you
KERALA,TRIVANDRUM,THIRUVANANTHAPURAM
belong
9. (a) District/Circle to which you apply
N.A.
(In the case of District wise selections)
(b) Have you applied for the post in any other
N.A.
district as per this notification? (Yes/No)
10. Are you eligible for relaxation of upper age
limit? NO
if so give details
11. Are you entitled to weightage / Priority being
Sportsman/Ex-serviceman/Physically NO WEIGHTAGE
Handicapped? NO PRIORITY
Give details
12. Are you employed on a regular basis under YES,STATE
State or Central Government? WORKING IN CENTRAL POLYTECHNIC AS TRADESMAN
Give details COMPUTER SINCE AUGUST 30
13. Are you presently ineligible to apply for the
post on account of debarment by Public Service
Commission, dismissal from service or conviction NO
by a Court of Law?
Give details
DECLARATION
I hereby declare that all the particulars furnished above are correct and complete to the best of my knowledge and belief
and that I am in possession of the documents in proof of the claims made in this application.
Place : KUNCHALUMOODU sd
Date : 27/12/2010 4:05:19 PM Signature