REGISTRATION FORM EX-SERVICEMEN (JCOs/ORs)

1. Service : Army/Navy/Air Force.

2. Service Number: 15461800P

3. Rank : HAVILDAR

4. Name : PARMANAND GUPTA

5. Regiment : 89 ARMAD REG. 6. Trade : DRIVER/GUNNER
7. Fathers Name : RAMADHAR GUPTA

PHOTO

8. Date of Birth :
9. Record Office Address: ...
10. Educational Qualification :
(a) Service :
(b) Civil : ....
11. Experience in Civil Job (if any) :
12. Special Expertise (like NSG, Commando, Technical, Computer Course, Security Course etc).
....
13. Have you attended any DGR sponsored course, if so specify detail : .....
14. Enrolment Date : 15. Medical Category (including % of disability)
16. Date of Retirement/Discharge : ...
17. PPO No. (attach photocopy) : ..
18. Details of Weapon(s) held with Licence No. : ....
19. Type of Job Preferred (Three Choices)
I. .. II. . III ...
20. Preferred Location of Job (Three Choices of state)
I. .. II. . III ...
21. Are you in possession of Civil Driving Licence?
If so, is it for both LMV & HMV or only for LMV
22. Permanent Address : ...
....
....
23. Present Address : .
....
....
24. Contact Number : (a) Landline : .. (b) Mobile : ....
25. E-mail Address (if any) : .....
Note :- 1. Registration Form duly completed can also be sent to DGR on following e-mail address
employmentdgr@yahoo.in
2. Photo copy of Discharge Book/PPO must be attached with this form.