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Application form for WBCS Exam 2009

Application form for WBCS Exam 2009

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Published by jaipurite
Application form for WBCS Exam 2009
Application form for WBCS Exam 2009

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Published by: jaipurite on Sep 04, 2008
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09/13/2010

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PUBLIC SERVICE COMMISSION, WEST BENGALAPPLICATION FORM
West Bengal Civil Service (Executive) Etc. Examination, 2009
ADVERTISEMENT NO. 10/2008Closing date for receipt of Application : 30.09.2008.
 
Space for pasting ofrecent passport sizephotograph of thecandidate with his/herfull signature thereon.
Page 1 of 3
(i) A candidate should consult the
Information Brochure 
and fill inthe application form correctly against all the items in his/her ownhandwriting in black/blue ink and furnish required documents/ particulars. Incomplete or defective application will be summarilyrejected.(ii) Correction/overwriting should strictly be avoided. If done, itshould be accompanied by signature of the candidate.
Roll No.
(Space for office use only)
1.
(a) I.P.O./Treasury Challan attached for : Rs. _____________________ (b) I.P.O. No.(s) & Value :(c) Date of purchase and name of issuing :Post Office with address(d) Treasury Challan No. & Date :
2.
Name in Full :(IN CAPITAL LETTERS)
3.
* Choice of Preliminary Examination Centre(Use Code Number indicated at the end of the form)[candidates suffering from blindness or low vision requiring the help of a Scribe should opt Kolkata (South) Centre only ]
4.
(a) Community / Category Gen BC SC ST PWD
(Person with disability)
[ Put
 
’ mark in appropriate box(s) ](b) Whether SC/ST/BC Certificate obtained Yes Nofrom competent authority of West Bengal :[ Put
 
’ mark in appropriate box(s) ](c) If SC/ST/BC Candidate, mention : Sub-Caste State Issuing Authority(d) (i) In case you are a person with disability (PWD), state the Category (Put ‘
’ mark in the appropriate box) :Suffering from blindness or low vision Hearing Impaired Orthopaedically Handicapped(ii) In case you are a person with blindness or low vision, mention if you require the help of a Scribe : Yes No
 
(Put ‘
’ mark in appropriate box)
5.
Sex (Put
mark in appropriate box) : Male Female
D D M M Y E A R
 
6.
(a) Date of Birth (as recorded in Madhyamik or equivalent examination Certificate) :
Centre NameCentre Code
(b) Place of Birth (including District & State) : _____________________________________ 
 
7.
(a) Whether a Citizen of India (Put ‘
mark in appropriate box) : Yes No
8.
Father’s Name :(IN CAPITAL LETTERS)
9.
(a) Complete address for communication (IN CAPITAL LETTERS) mentioning locality,Post office, Sub-Divn., Dist. and Pin-Code :(b) Permanent Address :
10. Educational Qualification (Madhyamik and onwards)
:
[ Attested or self-certified copies of all certificates must be attached to the application]Name of ExaminationYear ofpassingBoard/University Subjects takenDivision/ Class
11. Mark (with
’) your choice of language in : Bengali Hindi Urdu NepaliCompulsory Paper – I12. (a) Do you have the ability to read, write and speak : Yes No
 
in Bengali (Put ‘
’ mark in appropriate box)(b) Whether you are a Nepali speaking person : Yes Nofrom hill areas of the District of Darjeeling(Put ‘
’ mark in appropriate box)(c) State your mother tongue :13. Indicate Group(s) you like to compete for : A B C D(mark with ‘
’ in box according to choice – videpara – 6 in ‘Information Brochure’)14. (a) Mention your height in c.m. accurately :
c.m.
(for candidate intending to be consideredfor Group ‘B’ Service).(b) (i) Do you claim relaxation in height? : Yes No
 
(Put ‘
’ mark in appropriate box)(ii)
 
If so, state your race :
 
15. +
Optional subjects
: Name of Optional Subject CodeMention clearly the name(s) of Optional subjects with : 1.code after consulting Appendix-I paras 2, 3 & 4 of theInformation Brochure. 2.
16. If you have at any time been employed, give details
:-
Office where employedand state whether Govt./ Local/ Statutory body orprivate concernDate of joiningDate ofleavingCause ofleavingName of PostheldPermanent ortemporary oron contractbasis
Present Salary
Pay-Allowances
Page 2 of 3

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