You are on page 1of 1

APPLICATION FORM

1. 2.

Post applied for Name of the Division (Ranked on priority) (In case of District having one Division no need to mention ranking i.e., only Division name should be mentioned)

: :
1. 2. 3. 4. 5. 6.

District :

Affix latest passport size photograph

3. 4.

Name (Mr./Ms./Mrs.) Date of Birth & Age as on 01.07.2012 (Years & Months) Fathers / Husband Name Present Address with Pin code and Phone / Mobile No./ e- mail (if any) Nationality & Religion Mother Tongue Caste (SC, ST & BC) Local (or) NonLocal Educational Qualifications

: :

5. 6.

: :

7. 8. 9. 10. 11.

: : : : :
SSC Inter Graduation P.G Year of Passing University Division/grading % Marks

12.

In case of Employee: a. Name of the Post being held b. Name of the employer

13. 14.

: Employment Registration No and place of Registration Mode of Written Exam (Telugu /English /Urdu) Date: Place: NAME OF THE CANDIDATE AND SIGNATURE DECLARATION I hereby solemnly declare that all the statement made in the above application are true and correct to the best of my knowledge and behalf. I fully understand that in the event of any information being found false or incorrect, appropriate action can be taken against me. :

NAME OF THE CANDIDATE AND SIGNATURE


Instructions: i. One Application for one Category in a District. ii. Self Addressed Envelope (size 12x28 Cms) with Rs.5/- Stamp affixed on the cover should be enclosed with application. iii. Attested copies & following documents must be enclosed: a. Community, Nativity & Date of Birth Certificates b. School Study Certificate (from SSC on wards) c. Certificate of Residence d. NCC Certificate (A,B & C) if any e. Two passport size photographs.

You might also like