வ�வா� நி�வாக� ம��� ேப�ட� ேமலா�ைம ஆைணயரக�

கிராம உதவ�யாள� பதவ��� இைணயதள வ��ண�ப�

வ��ண�பதார� வ�வர�க� / Applicant Details

Registration ID:28126409636

Submitted Date/Time:2022-11-06 23:10:40.137054

வ��ண�பதார�� ெபய�
Karthika
Name of the Applicant
வ��ண�பதார�� ெபய� தமிழி�
கா��திகா
Name of the Applicant in Tamil
த�ைத /கணவ�� ெபய�
Thangam
Father/Husband Name
ெதாட���கான �கவ� 370B-3-PILLAIYARKOVILSTREET-THULUKKANKULAM-
Address for Communication PILLAIYARKULAM(POST)-SRIVILLIPUTTUR(TALUK)
ப��ேகா�
626137
Pincode
பாலின�
Female
Gender
ேதசிய�
Indian
Nationality
ம�றவ�
-
Nationality other than Indian
மத�
Hindu
Religion
ேமேல உ�ள ப��யைல� தவ�ர ேவ�
ஏேத�� இ��தா� மத�தி� ெபய� -
Name of the religion if any other than above list
ச�க�
BC
Community
ப�ற�த ேததி
20-04-1991
Date of Birth

ெசா�த மாவ�ட�, தா�கா ம��� கிராம வ�வர�க� / Native

District,Taluk,Village details

இ��ப�ட மாவ�ட�
Virudhunagar
Native District
இ��ப�ட வ�ட�
Srivlliputhur
Native Taluk
இ��ப�ட� கிராம�
Pillaiyarkulam
Native Village
வ��ண�ப��க�ப�ட கிராம�தி� ெபய�
Thailakulam
Name of the Village to which applied
ெதாட�� வ�பர�க� / Contact Details

ெமாைப� எ�
8610133904
Mobile Number
மி�ன�ச� �கவ�
volleyballkarthika@gmail.com
Email ID

க�வ� ம��� ெதாழி���ப த�தி வ�வர�க� / Educational and Technical

Qualification Details

க�வ�� த�தி
Other Higher Qualifications
Educational Qualification
ெதாழி���ப� த�தி
-
Technical Qualification

ஓ��ந� திற� வ�வர�க� / Driving Skill Details

ைச�கி� ஓ��த�
Yes
Bicycle riding
வாகன� ஓ��� திற�
Two Wheeler
Vechicle Driving Skill
ஓ��ந� உ�ம எ�
TN8420180006670
Driving License Number
உ�ம� ெச��ப�யா�� ேததி
02-08-2038
License Validity Date

ம�ற வ�வர�க� / Other Details

ப��க�� எ�த�� ெத��த

ெமாழிகள�� வ�வர�க� Both
Details of Languages Known for Read and Write
��ற வழ�� ஏேத�� இ��தா� அத�
வ�வர�கைள -
Details of Criminal Case if any

பதிேவ�ற� ெச�யேவ��ய ஆவண� / Upload Documents

�ைக�பட�
Photograph

ைகெயா�ப�
Signature

இ��ப�ட� சா�றித�
Document Attached
Native Certificate
 க�வ�� த�தி� சா�றித�
Document Attached
Educational Qualification Certificate
ஓ��ந� உ�ம�
Document Attached
Driving License
சாதி சா�றித�
Document Attached
Community Certificate
��னா� பைடவர� � சா�றிதைழ
-
Ex Servicemen Certificate
மா�� திறனாள�க��கான சா�றிதைழ
-
Physically Challenged Certificate

உ�தி ஆவண� / Declaration

ேமேல உ�ள அைன�� தகவ�க�� உ�ைம எ�� இத� �ல� உ�தியள��கிேற�

I hereby declare that all above information are true

Attached Documents
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