APPLICATION PROFORMA

To
Chief Workshop Manager(Personnel),
Mechanicial Workshop,
N.E. Railway, Gorakhpur.

Self sign.
photo

Sub:- Application for selection of Trade Apprentice Trainees.

Ref:- Notification No. E/227/IV/5/Pt.X.V dated 02.06.2015

**********
In reference to above notification I hereby submit my application for selection as Trade Apprentice Trainees and I
also governed by the provision made in Apprentice Act, 1961 and revised time to time.
1.

Name of Applicant:

2.

Fathers Name :

3.

Permanent Home Address:

..

Vill./Moh.P.O. . Distt. .
StateTelephone No. .
4.

Address for Correspondence:

Vill./Moh.P.O. . Distt. .
StateTelephone No. ...
5.

Nationality .CasteReligion..

6.

Whether SC/ST/OBC submit the caste certificate duly attested by Gazetted Officer.

7.

Date of Birth:

submit attested copy of certificate.

8.

Age of Applicant

Year Month Days

9.

Married/unmarried

10.

Qualification
Exam

Year

Name of Institute

Subject

% of Name
of
Marks Education Board

11.

In support of above qualification applicant should submit attested copy of marksheet and certificate.
Any other qualification:-

12.

Two marks of identification:- ..

13.

Character certificate issued by two Gazetted Officer.

14.

If applicants father is Rly Employee submit the Department certificate in this connection on enclosed
proforma.
Signature of Candidate

APPLICATION FORM FOR THE ACCEPTANCE OF PATWARI

CANDIDATES IN SETTLEMENT DEPARTMENT HIMACHAL PRADESH.
1. Name of the Candidate:-

(In Block letters)

2. Fathers Name:-

________________________________________

_______________________________________

3. Date of Birth:-

________________________________________

2. Correspondence Address
House No/Village :-

_______________________________________

Post Office/Tehsil/Sub-Tehsil ____________________________________

Affix recent
passport
size
photograph
duly
attested by
a Gazetted
officer

District:________________________________________________
State:-

________________________________________________

Pin Code:-

________________________________________________

Contact Number:-

________________________________________________

3. Permanent Address
House No/Village :-

________________________________________________

Post Office/Tehsil/Sub-Tehsil /_______________________________________________

District:-

________________________________________________

State:-

________________________________________________

Pin Code:-

________________________________________________

Contact Number:-

________________________________________________

4. Category/Sub-category to which He/ She belongs_________________________________________

5. Educational Qualification:- ______________________________________________________
6. Any other qualification /experience:-

______________________________________________

7. Fee Rs.______________ Demand Draft No.__________________________ Date_____________

8. Whether registered in any employment exchange Yes/ No:-

________________________

9. If Yes, Registration No. and name of the employment exchange:- ______________________

__________________________________________________________________________
10. I hereby declare:(a) That I am not involved in any criminal case and no criminal proceedings are contemplated
against me in any court of law.
(b) That the above particulars mentioned in the application are correct and true to the best of my
knowledge and belief. If particulars mentioned by me are found false at any stage, then my
candidature I shall be liable to be terminated without any notice.

Dated :applicant)

(Signature

of

the