APPLICATION FORM

(Selection of Typist-cum-Computer Operators)

1

Application ID

Applicant Name

Father / Husband Name

Address with Postal Code

Village

Mandal

D.O.B

Age (as on 30-05-2015)

Mobile No.

10

e-Mail ID

10

Caste

11 (a)

Caste certificate enclosed or not (only for

SC / ST)

If yes No./Date/issuing authority

(b)
12 (a)
(b)
(c)

Whether applicant is resident of Agency

Area (only for ST)
If yes Agency Area certificate enclosed or
not (only for ST)

14 (a)
(b)

:
:

If yes no/date/issuing authority

Educational Qualifications :
13 (a) SSC memo enclosed or not
(b) If yes details
Sl.
No.

:
:
Institution

Graduate memo enclosed or not

:
If yes details
:
Sl.
Institution
No.

Technical Qualifications :
15 (a) Type writing Certificates enclosed or not,

(b)
16 (a)

If yes details
PGDCA Certification enclosed or not,

:
:
:

(b)

If yes details

17

Others (Computer)

18

All the Certificates are with Gazetted

Attestation or not

Year of
Passing

Percentage
of Marks

Year of
Passing

Percentage
of Marks

Signature of the Applicant