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. 1 / 2011 - 2012 Instructions for filling up the application : Application may be filled up either in English or Hindi. One envelope should contain application of one candidate only. The envelope containing the application must be superscribed in bold letters as APPLICATION FOR THE POST OF SECURITY GUARD. Application shall be rejected if it is not in the prescribed format, contains incomplete information without attested photograph pasted at the appropriate place and application received late. Original / photo copies of certificates should not be attached with the application.

Full Name of A} Applicant : B) Father :



FATHERS NAME Paste a signed latest Passport Size Photograph

Whether Male/Female Male Female Tick appropriate box Full Address for____________________________________________________________________ Communication ___________________________________________________________________ .(with Pin-Code) ___________________________________________________________________ Date Date of birth Age (As on 31/12/2011) Educational Qualifications: As on Standard passed Marks obtained ____ Years Out of _____ Months Percentage Month Year

Name of Educational Institution last attended and place/State Name Place State

Category : Tick appropriate box SC ST OBC Gen Ex-Servicemen

Displaced persons from Jammu & Kashmir between 1.1.1980 and 31.12.1989 Proficiency in Sports/ Extra Curricular Activities, if any

Ex-employee of Banking Institution / Govt. Office retrenched after at least one years service

I hereby declare that all the information & particulars furnished hereinabove are true and correct. I understand that if at any of the information is found incomplete/incorrect, false, misleading, my candidature is liable to be cancelled at any stage before appointment, if appointed, my appointment is liable to be terminated without notice or compensation in lieu thereof. I also understand that my candidature will be considered subject to criteria/conditions stipulated in the advertisement.

PLACE : DATE : _______________________ (Signature of the Applicant) Name: