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Name of the candidate Date of Birth

Sl No Post No. Sex

(In BLOCK LETTERS) (dd/mm/yyyy)

1 1343
Marital Status Category Whether Persons with Disabilities Type of Disability
(Single/Married) Nationality (UR/OBC/SC/ST) (Type Yes or No) (OH/VH/HH)
Whether Ex-servicemen
Percentage of Disability Father's/Husband Name
(Type Yes or No)
Address Line1 Address Line2 Address Line3
District State Pincode email_id
Nearest Railway SSLC/SSC/Military Qualification
Mobile Number Station (Please Type your qualification from the above)
SSLC/SSC/Military Qualification ITI/NTC/NAC
Percentage of marks (Please Type your qualification from the above)
ITI/NTC/NAC State Council from which Number of years of work
ITI/NTC/NAC Trade Percentage of Marks ITI/NTC/NAC obtained experience
Number of months of work Have you done apprenticeship in VSSC?
experience (Please type Yes or No)
Whether you have applied online
against VSSC Advertisement No.297 for Name of the Employment Exchange
this post ? If the answer is "Yes", please you have been sponsored from
type the online registration number
received from VSSC website.
Your Registration Number in the
Employment Exchange