THIAGARAJAR POLYTECHNIC COLLEGE, SALEM 636005

NAME OF THE POST .

BIO-DATA

1. Name (In capital letters) : ______________________________

2. Father's name : ______________________________ Affix recent

Passport size
Photograph duly
D M Y attested by
3. Date of birth :
Gazetted officer

Y M
4. Age :

5. Community/Caste :

Male Female
6. Gender :

Single Married
7. Marital Status :

8. Address with PIN Code : ______________________________________

______________________________________

______________________________________

e-mail id : ______________________________________

Mobile Number : ________________Landline Ph:_____________

9. Qualifications : (attach attested photocopies only)

S. Academic / Discipline Name of the Board / year of % of

No. Technical Institution University Passing Marks
Qualification
 10. Details of Experience : (attach photocopies only)

S. Name of the organization Designation Experience Salary drawn

No. Years Months Days per month

Total Experience

11. Any other relevant information

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Declaration:

I hereby declare that all the information furnished above are true to the best of my
knowledge and belief.

Place: Signature:
Date: Name:__________________