Application Form

Application Number
Token / Transaction

: 101050105127473
: 1501010501859984

1. Exam Details
1.1 Examination Name
1.2 Examination Post
1.3 District Head Quarter for Exam
1.4 General Subjects (PRE)

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Payment Mode : Netbanking

Bank Ref. No
: IG0AYUNWS1

Application Filled Date

Reference Application

: 08/11/2015 2:07 PM
: 101050105127473

ASSISTANT AGRICULTURE OFFICER 2015

ASSISTANT AGRICULTURE OFFICER
AJMER
ASSISTANT AGRICULTURE OFFICER

1.5 Optional Subjects (PRE)

1.6 General Subjects (MAINS)

1.7 Optional Subjects (MAINS)

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1.9 Medium Of Exam

1.10 Aadhar Number

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: 788939807035

2. Department Preferences
2.1 Department Preference

3. Applicant's Details
3.1 Applicant's Full Name
3.2 Applicant's Father Full Name
3.3 Applicant's Mother Full Name
3.4 Date Of Birth (dd/mm/yyyy)
3.5 Gender
3.6 Marital Status
3.7 Category
3.7.1 TSP Area (If Any)
3.8 Home State (Bonafide Resident)
3.9 Home District

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GOKUL CHAND
KASHI RAM
SUMITRA DEVI
10/07/1985
MALE
Married
SC
RAJASTHAN
HANUMANGARH
Photo & Signature
Of Candidate

4. Other Special Categories

4.1 Category for Disabled Candidates
4.2 Specific Category for Female
4.3 Other Category

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5. Correspondence Details
5.1 Address

5.2 Email
5.3 Phone
5.4 Mobile
6. Qualification

: VILL-SWAICHHANI ,
CHHANI BARI,Tehsil : BHADRA,City/Village : BHADRA - 335511
Dist : HANUMANGARH, State : RAJASTHAN
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: 9351329552
Year

6.1 Secondary
6.2 Sr. Secondary
6.3 Graduation
6.4 Post Graduation
7. Additional Qualifications/Specifications
7.1 Other Specification/Qualification
7.2 Examination passed
7.3 Internship Period
7.4 Experience
8. Identification
8.1 Body Mark
9. Disclaimer

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: 2003
: 2007
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Division/Grade

Second
First
Second

Passed

: RSCIT, AGROCLINIC DIPLOMA

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: MARK OF MOLE ON RIGHT HAND

I hereby declare that all information made in this application are true, complete and correct to the best of my knowledge and belief. In the event of my information being found false or incorrect or the ineligibility
being detected before or after the Screening Test/Interview, action can be taken against me by the Commission. I have read the provisions of the relevant rules and the Advertisement carefully and I hereby
undertake to abide by them. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualification and required experience etc. prescribed for admission to the Screening
Test/Interview. Also I accept SMS facility provided by the Commission.

Rajasthan Public Service Commission

Ghooghara Ghati, Jaipur Road, Ajmer
Phone : +91+145+ 5151200, 5151240 & 5151090

Nodal Officer: Mr. Akhilesh Mittal, System Analyst (Joint Director)

Help Line : 0145-5151212