Application Form PLEASE FLL UP THE APPLICATION FORM AND EAUALITS SCANNED COPY TO NaME oF Post APPLIED FoR: | COUNSELLOR, Pease put your signature 4. NAME OF CANDIDATE: seron the photograph erstmme: — (PIORITIDIALE LL I (MIDDLE NAME: LT I I I 7 ei} “la surmame: — (BIAIRIVIALH! | | OS 2.ratHeR’s name: [Z/AIMIT) ALMUL [BIALRIVIALPI Stale lalalal s.morner'snae: Gloiaiiimia| | isialrivial | | een fe 4)GENDER: MALE [7] FeMaLE[[J~~ S)DATEOF BIRTH (COMM) CTT] (LS) QS TaTG @)AGE (es on01-012047) Years ZTEC] Months [TG] oaye [TE] 7) PERMANENT ADDRESS: Gia TR INT A eto TaD bie] WRolelwiAlrl f | 11 Litt foam] Pole turaltl 1 11 es en ia | Semen eT eee ee Ts] Bt ee Et | Pin code: zi B al ¢l S16 TO TT us [mrs ee a ee) ies)'8) ADDRESS FOR CORRESPONDENCE: nosh TATE — ee ett Ler Ed fia fo ~ terete 1 (Etat e101 iene Sa Te ie IML 1 1 1 11 a Ctetcrotons FT 9) MOBILE NUMBER: Eo oe ttt} soy e-MaLio: [Po gpar-Baevaw(® Gmale. COM - 11) EDUCATIONAL QUALIFICATIONS. QUALIFICATIONINAME SUBJECTSISPECIALIZ| YEAR OF GRADE? | as DEM) ‘OF COURSE UNVERSIYIBOARD ATION passinG | PERCENTAGE th MATHS, com AS, ms Semaee | PSice SEBA paren leon | CT haher eng. Tet J Seconda 1 7! - OK ‘ re AALS prsec —_ |gitony bie, gos | 74 “anton | BACHELOR'S ; 2olk |g. / ee IN SOCIAL Wor! en Soa ? § (8 5 Post MASTERS IN| +160 VOI] E'3 (gh ch ie 5 utah cD) ny Others 42) PROFESSIONAL EXPERIENCE: Employment details (Please add extra sheets If required) DURATION ‘st | DESIGNATION ORGANIZATION. |" For, To "Total JOB RESPONSIBILITIES No Ga months) - ¢ NEF Coteny as” | PReser| TE ACHINY ( Asset Wicd 2n : 4 iia ai usToM ER INDIGO. lo4acly) eat ain 4 (3 (ere apriees| Ae cuts wl 4 Pustodlers (FEE DY pore we | es ays)13) TRAINING AND OTHER COURSES ATTENDED, DURATION SL] NAME OF TRAINING ‘OTHER | NAME OF INSTITUTE From To Totar No_ | CouRses ATTENDED 1 [Comparer Cane TANTT RON APT ion Tonalin |B wort (eedry 14) LANGUAGE KNOWN: (PLEASE TICK \) SUNO_[LANGUAGE WAITING [READS [SPERGNS O EndGyis = = C2 @ | pssanece cae | AC | a @ Hip) Aa za a Declaration: etre yetgclae that all the statements made by me in the application form and Information sheet are true and complete any of mo state Rnowledge and belief and nothing has been concealed or suppressed. | also understand that in eese, seeied ry atements fs found untrue during any stage of recruitment and thereafter, | shall be disqualifid for the voce applied for and | shall be liable for any penal action. ate: 25/07 [2019 Signature of the Candidate ee Prcoke anon