APPLICATION FORM - "A"

FOR THE POST OF ADVISOR

Post applied for * :  Advisor (Economic Sector) [Adv-001]

(Candidates should indicate for which post
he/she is applying for and  the appropriate  Advisor (Social sector development) [Adv-002- Recent Passport
box) A] Size Color Photo
 Advisor (Public food systems) [Adv-002-B] with signature on
it
 Advisor (NRM and decentralised
Governance) [Adv-003]

Name (in capital Letters) :

Father’s / Husband’s Name :
Date of Birth :
(dd/mm/yyyy)
Please specify if you belong to SC/ ST/OBC :
(attach certificate)
Address for correspondence Permanent Address

Pin code:……….. Pin code:………..

Mobile No. :
Email Address :
Note: * Separate application is required for each post applied.
** Upper age limit for the post is 35 years as on the month of publication of advertisement)

Educational Qualifications:
Qualification Board/University Year of %age of Subjects
Passing Marks
Matriculation/
HSC
Graduation

Post Graduation

Diploma

Any other

(Self attested copies of mark sheets must be attached with the application)
Work Experience:
Name of Employer/ Date of Date of Experi- Job Title/ Pay Scale with Job Responsibilities
Department Joining Relieving ence in Designation grade pay and
years total emoluments

Note: Serving government servant should submit his/her application through proper channel.

Any other relevant information :

Declaration
I, ……………………………….. solemnly declare that the above information is true as per my knowledge and belief and I have
enclosed necessary documents. I have not been punished in a court case or in any departmental enquiry. No such cases are
pending against me.

Place:…………………. Signature:…………………………………..
Date:……………..
Name of Applicant:………………………..
 APPLICATION FORM - "B"
FOR THE POST OF ADVISOR

Post applied for * :  Advisor (Urban Governance) [Adv-004]

(Candidates should indicate for which post
he/she is applying for and  the appropriate  Advisor (State Health Resource Centre) [Adv- Recent Passport
box) 005] Size Color Photo
 Advisor (KM and e-Governance) [Adv-006] with signature on
it
Name (in capital Letters) :
Father’s / Husband’s Name :
Date of Birth ** :
Please specify if you belong to SC/ ST/OBC :
(attach certificate)
Address for correspondence Permanent Address

PinCode:……….. PinCode:………..
Contact No. :
Email Address :
Note: * Separate application is required for each post applied.
** Upper age limit for the post is 35 years as on the month of publication of advertisement)

Educational Qualifications:
Qualification Board/University Year of %age of Subjects
Passing Marks
Matriculation/
HSC
Graduation

Post Graduation

Diploma

Any other

(Self attested copies of mark sheets must be attached along with application)
Work Experience:
Name of Employer/ Date of Date of Experi- Job Title/ Pay Scale with Job Responsibilities
Department Joining Relieving ence in Designation grade pay and
Years total emoluments

Note: For serving government servants the application should be submitted through proper channel.

Any other relevant information :

Declaration
I, ……………………………….. solemnly declare that the above information is true as per my knowledge and belief and I have
enclosed necessary documents. I have not been punished in a court case or in any departmental enquiry. No such cases are
pending against me.

Place:…………………. Signature:…………………………………..
Date:……………..
Name of Applicant:………………………..