SOFTWARE TECHNOLOGY PARKS OF INDIA

(An autonomous Society under Department of Information Technology, Govt. of India)

APPLICATION FORM

Advt. No.STPH/01/2010

Please affix passport

1. Please fill the application with Candidates own size Photograph duly
hand writing and in CAPITALS only signed
2. One extra photograph of the candidate to be sent
along with the application

Details of Demand Draft/IPO :

(Please write your name & Post Code on reverse of the Demand Draft)

DD/IPO No._______________ Date: ______________ Amount (Rs.)________________

Bank/Post Office : ________________________________________________________

Post Applied for ________________________________________________________

1. Name __________________________________Surname ____________________

2. Father’s Name __________________________________________

3. Date of birth (DD/MM/YY) ____________________

In Words _____________________________________________________________

4. Do you belong to SC/ST/OBC/EXS/PH Category Yes / No

(If yes, please give details)

5. Address for Correspondence 6. Permanent Address

_____________________________ __________________________

_____________________________ __________________________

_____________________________ __________________________

Contact Tele Numbers Contact Tele Numbers

(O) ____________________ (O) ____________________
(R) ______________________ (R) ____________________

Email ID : ______________________________
 7. Educational Qualification (Start from S.S.C.). Enclose copies of certificates

Sl. Exam Passed University/ Board Year of Subjects % of marks No. of

No. passing Passed & Division attempts

8. Past/Present Experience (start from Present) Enclose copies of certificates

Name of the Please indicate Designation, Period Nature of Duties &

employer with whether Govt/ Pay Scale & Responsibilities
address Semi Govt./ Salary
Public From To
Undertaking/
Private

9. Language in which test/interview preferred : Hindi / English

10. a) Have you applied any other post against this advertisement : Yes/No

b) If Yes, details of the post applied

 11. Any other information, the candidate may like to add

12. Declaration:

I do hereby declare that all the statements made in this application are true, complete
and correct to the best of my knowledge and belief. I understand and agree that in the
event of any information being found false or incorrect/incomplete or ineligibility
being detected at any time before or after selection/Interview, my candidature is liable
to be rejected, I shall be bound by the decision of the Director, STPI, Hyderabad.

Place:

Date:

Signature

Part – II

(To be filled in by the Competent Authority in the case of candidates who are presently
working in Government / PSUs / Autonomous Organizations only)

Certified that :-

(i) The information given below by the officer is correct.

(ii) No vigilance / disciplinary proceedings are either pending or contemplated
against the above mentioned officer.

Signature : _____________________

Name : _____________________

Designation : _____________________

Date: ________________________ Department : _____________________