PROFORMA

Application for the post of

BIO-DATA
1. Name (In Block Letters).

2. Fathers Name.

3. Date of Birth (In Christian era) In numerals: ...

In words:

4.
(a) Address for Correspondence.

:.
..
..
..

(b) Contact Telephone Number.

(c) E-Mail ID, If any.

5. Permanent Address.

:
.
.
.

6. Nationality & Religion.

:
:

7. Whether SC/ST/OBC/General.

:...
...

8. Marital Status.

:..

9. Educational Qualification.
Examination
Passed

Name of
University

9 A: Computer Knowledge:

Year Subject Marks

Class/ Division/ % of
Marks

10. Experience:
Sl.
No.

Name of
Post

Name of the
Organization

Nature of Job
Assigned

Pay Drawn & Scale

of Pay Before
Leaving

From To

11. Are you under contractual obligation to serve the ..

Central Govt./State Govt./any other Public Sector .
Undertaking? If so, please furnish full details: ....
12. Any other information you may wish to add: ..
I hereby certify that the information given above is true and correct. In case any
information is found to be false, I am aware that in case of my appointment, the same is
liable to be terminated as per the terms and conditions of appointment.
Place:
Date:

Signature:

Attested copies of certificates to be enclosed:

1. Date of Birth;
2. Educational Qualifications;
3. Community Certificate:
4. Experience Certificate;
5. Computer Literacy Certificate;
6. Any other certificate.