VAJIRAM & RAVI

(A Unit of Vajiram & Ravi Educational Services)

[INSTITUTE FOR IAS EXAMINATION]
9-B, Bara Bazar Marg, Old Rajinder Nagar, New Delhi 110 060
Tel. No. 25820000, 25734058, 43306017

APPLICATION FORM
UPSC Roll No.: _________________
(if received)
1. Name in Full: _________________________________
(in Block Letters)
2. Date of Birth: _________________________________

Staple THREE Passport

size photographs here

3. Father's Name: _______________________________

Occupation: __________________________________
4. Do you belong to SC/ST/OBC? (Yes / No)
(If yes, please mention the category) ____________________________
5. Permanent Address:

_____________________________
_____________________________
_____________________________

6. Mailing Address

_____________________________
_____________________________
_____________________________
Tel./Mobile No. _________________

7. E-mail Address

_____________________________

8. Particulars of Educational Qualification

___________________________________________________________________
Examinations
Name of College/
Passed
University
( Note: to be filled from 10th std )

Year of
Passing

Subjects
Offered

Percentage of marks
obtained

___________________________________________________________________
Payment Details: Bank DD No.----------------

dated--------------

Bankers Name --------------------------------

Amount Rs.___________

P.T.O

9. Have you appeared in the Civil Services ________________________________

Examination earlier?
If so, write the year and marks obtained: ________________________________

10. Mention subjects for which personal

i) PRELIM-CUM-MAIN

guidance is required:
(a) General Studies Yes/No
(b) CSAT

Yes/No

ii) MAIN EXAMINATION:

(a) General Studies: Yes/No
(b) Optional:

---------------------------------

11. Mention subjects for which postal

MAIN EXAMINATION

guidance is required:
(a) General Studies: Yes/No
(b) Optional:

---------------------------------

Signature of Applicant

Place: ______________
Date: _______________

---------------------------------------------------------------------------------------------------------------FOR OFFICE USE ONLY

Admitted on _________________________ for_____________________________

Date:___________

ADMINISTRATIVE OFFICER

COURSE DIRECTOR