APPLICATION FORM

I. PERSONAL PROFILE

1. Name of the Candidate: (Capital letters)

Surname

Name

2. Fathers / Spouse name:

3. Social Status

: SC ST BC-A B C D E OC Min

4. Date of Birth

: DD MM Year

5. Nationality

6. Marital Status

: Married Unmarried

7. Native District 8. Native state

: : AP Other specify the state 10. Address for communication

9. Permanent address

Pin code :

Pin code :

11. Cell No.

12. E-Mail ID

II ACADEMIC DETAILS

(Start from First Degree / Graduation onwards)

S.No Group Subject Course type (Regular / Correspondent) Board / University Year of passing % of marks

Technical qualification: S.No. Subject Board / University Year of passing

Computer skills: 1. Knowledge of Hardware 2. Knowledge of Networking 3. Knowledge of Computer Programming 4. Practical knowledge of MS Office 5. Knowledge and usage of Internet : : : : : Good Good Good Good Good / / / / / Fair Fair Fair Fair Fair / / / / / None None None None None

III WORK EXPERIENCE INFORMATION: Details of function handled (Service matters, Agrl., Dairy, Banking etc.,) Duration Place From To

S. No.

Designation

Department / Institute / Organisation name

a. Last pay drawn (Enclose with salary certificate and one year bank statement of salary a/c)

: Rs.

b. Industrial knowledge (Agrl., Dairy, Banking, Financial, Rural development, etc., )

c. Functional area

d. Achievement and projects

e. Key skills

f. Publication of Books if any S.No. Title of the Book

: Year of published

g. Publication of papers if any S.No. Topic

: Year of published

h. Appreciations / Rewards received if any

IV. PURPOSE OF JOINING IN SERP :

1. Unit in which he/she is interested to work: (Land / Dairy / Education / NPM etc.)

2. Reasons for choosing SERP to work in General and particular unit specifically: (not more than 200 words)

SIGNATURE OF THE APPLICANT