VAJIRAM & RAVI

[INSTITUTE FOR IAS EXAMINATION]

9-B, Bara Bazar Marg, Old Rajinder Nagar, New Delhi – 110 060
Tel. No. 25820000, 25734058, 43306017
Website: www.vajiramandravi.com

APPLICATION FORM
UPSC Roll No.: _________________
(if received) Staple THREE Passport
size photographs here
1. Name in Full: _________________________________
(in Block Letters)

2. Date of Birth: _________________________________

3. Father's Name: _______________________________

Occupation: _________________________________

4. Do you belong to SC/ST/OBC? ( Yes / No )

(If yes, please mention the category) ____________

5. Permanent Address: _____________________________

_____________________________
_____________________________
6. Mailing Address _____________________________
_____________________________
_____________________________
Tel./Mobile No. _________________
7. E-mail Address _____________________________

8. Particulars of Educational Qualification

_____________________________________________________________________
Examinations Name of College/ Year of Subjects Percentage of marks
Passed University Passing Offered obtained
( Note: to be filled from 10th std )
______________________________________________________________________

_____________________________________________________________________

Payment Details: Bank DD No.---------------- dated--------------

Bankers’ Name -------------------------------- Amount Rs.____________ P.T.O……

9. Have you appeared in the Civil Services ______________________________
Examination earlier?

If so, write the year and marks obtained: ______________________________

10. Mention subjects for which personal i) PRELIM-CUM-MAIN

guidance is required:
(a) General Studies Yes/No
(b) Optional: -----------------
-----------------

ii) MAIN EXAMINATION:

(a) General Studies: Yes/No
(b) Optional: -----------------
-----------------

11. Mention subjects for which postal MAIN EXAMINATION

guidance is required:
(a) General Studies: Yes/No
(b) Optional: -----------------
-----------------

Place: ______________ Signature of Applicant

Date: _______________

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FOR OFFICE USE ONLY

Admitted on _________________________ for _______________________________

_____________________________________________________________________

Date:___________ ADMINISTRATIVE OFFICER COURSE DIRECTOR