APPLICATION/BIO DATA FORM 1.

Post Applied for : Junior Assistant

A((i) a *ass*ort si+e *hoto here,

2. Examination Centre : _________________________________ (Write the name of the Centre opted) Chennai Coimbatore Trichy Ma urai !i"aya#a a Ban$a%ore Tri&an rum 3. PERS !A" #E$A%"S: i. !ame of the Appli&ant : (in CAP%$A" "E$$ERS)

ii. Sex (' the appropriate &ol'mn) (ale )emale

iii. (arital Stat's: (arried*+nmarried (Stri,e-o't .hi&h is not appli&a/le) i0. !ame of )ather*1's/and (in&ase married):

0. #ate of 2irth : )ill in the format dd*mm*3333 0i. A4e as on 31.56.2511 7ears 0ii. Address for Comm'ni&ation (onths

State _______________________ Pin &ode: Phone !o. _________________________ Email %d. ___________________________ 0iii. Cate4or3: (8 the appropriate &ol'mn) 2C SC S$ Repatriate thers

ix. !ationalit3 : _________________ x. !ati0e Pla&e :

xi. "an4'a4es ,no.n : "an4'a4e Spea, Read Write

xii. A&ademi& * Ed'&ational *$e&hni&al 9'alifi&ation: 9'alifi&ation 7ear : (onth !ame of %nstit'tion * of Passin4 +ni0ersit3 * 2oard Per&enta4e of mar,s* ;PA

xiii. Professional (Comp'ter) 9'alifi&ation: !ame of the #e4ree* !ame of the %nstit'tion #iploma*others (spe&if3) 7ear of passin4

xi0. Experien&e : !ame of the %nstit'tion )rom $o #esi4nation

x0. #etails of Relati0es .or,in4 in Rep&o if an3 Emp.!o. !ame of Staff #esi4nation !at're of Relationship

<.)EE RE(%$$A!CE : !ame of the 2A!= #emand #raft !o. Amo'nt #ate of ##

6.#EC"ARA$% !:- % here/3 de&lare that the information f'rnished in this appli&ation are tr'e > &omplete and &orre&t to the /est of m3 ,no.led4e and /elief.

Si4nat're of the Candidate