TANSI

Please affix a

APPLICATION FOR THE POST OF .

self attested

APPLICANT
BELONGS TO:

SC

ST

MBC

1.

Name in full

2.

Father / Husbands
Name

3.

Sex

4.

Date of Birth & Age (*) as on 1.1.2015

Age

Male

Date

BC

BC(M)

Female

Month

Year

Nationality:

6.

Marital Status

7.

PERSONAL DETAILS (*) (Tick whichever is applicable)

Religion:
Married

Unmarried

Destitute
Inter Caste
Physically
Widow
Marriage
Challenged
Details of Employment Exchange Card, if registered
Registration No.
District in which Regn. was done
Full postal address
Permanent Address
with Postal Pin Code

Widow

9.
a)

b)

OC

Third Gender

5.

8.

recent passport
size photo

Cell No:

Pin Code

e-mail id:
Cell No:

Pin Code

Address for
correspondence with
Postal Pin Code

ExServiceman

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10.

MOTHER TONGUE /2nd

LANGUAGE IN SCHOOL /
COLLEGE
If Tamil is not mother tongue /
2nd Language, the details of test
passed in Tamil

11.

Community (*)

Certificate No. & date Issued by

OC

BC

MBC

DNC

12. EDUCATIONAL QUALIFICATION (*)

Sl.
Course
Registration
Year of
No.
No.
passing

i)

X Standard

ii)

XII Std.

iii)

Degree

iv)

Post Graduate

SC
% of
marks
obtained
with class

ST
Name of the
University / College
/ School

TECHNICAL QUALIFICATION FOR THE POST OF TYPISTS / STENO

TYPIST (only) : (Must have passed Computer Automation Course) (*)
Junior
Senior
a)
Typewriting -Tamil
b)
Typewriting -English
c)
Shorthand -Tamil
d)
Shorthand -English
14. PROFESSIONAL / TECHNICAL QUALIFICATION (*)
Sl.
Course
Registration
Year of
% of marks
Name of the College /
No.
No.
passing
obtained
Recognised University
with class
/ Board / Institution
13.

i)
ii)
iii)
iv)

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15.

ADDITIONAL QUALIFICATIONS (*)

i)
ii)
iii)
iv)
16. PREVIOUS EXPERIENCE, IF ANY.
Sl.
Name and
Designations
Period
No. designation of the
held
Organisation
From
To

Salary
drawn /
drawing
(p.m)

Reason for
leaving

i)
ii)
iii)
iv)
17.

OTHER DETAILS, IF ANY

i)
ii)
iii)
iv)
(*) Self attested Xerox copy of certificates shall be attached along with application.
DECLARATION
I, _________________________________________, Son / Daughter / Wife of
___________________________________ hereby declare that the details furnished in
this application are true, complete and correct to the best of my knowledge and
belief. In case if the details furnished by me above is / are found to be
incorrect or false at a later date, I am aware my candidature / appointment will
be liable to be terminated without notice. I also agree to abide by the terms and
conditions of appointment stipulated by TANSI and modified from time to time.
PLACE:
DATE :

SIGNATURE OF THE CANDIDATE.