Application No: W0800074829 Application Form Anganwadi Worker

DEPARTMENT OF WOMEN & CHILD DEVELOPMENT AND SOCIAL WELFARE

MURSHIDABAD DISTRICT

Application Form for Direct Engagement to the Post of Anganwadi Worker.

Post and Residential Details:

Post applied for : Anganwadi Worker

Project Name : Jalangi ICDS Project
Notification No. : 395/ICDS/JAL
Notification Date : 06/12/2022
Application Form Submitted On : 2022-12-24 16:37:03 from IP 103.175.169.113

Personal Details:

Applicant's Name * : PALI BISWAS

Gender* : Female
Date of Birth* : 13/04/1992
Age : 29Years
Father's Name* : SADHAN BISWAS
Mother's Name* : DIPALI BISWAS
Husband's Nme* : SAJAL SARKAR
Email ID* : sajal_civil@yahoo.in
Mobile No* : 8942984945
Nationality* : Indian Marital Status* : Married

Permanent Address as per the Voter Card (EPIC)/ Electoral Roll or in absence of electoral data, as per certificate of appropriate
authority

Address : MAHISHMARI, NATIAL

Village/Ward : MAHISHMARI
Block/Municipality : Jalangi
Sub Division : Domkal Post Office: : NATIAL
Police Station : Sagarpara Police Station District : Murshidabad
State : West Bengal Pin : 742308

Present Address:

Address : MAHISHMARI, NATIAL

Village/Ward : MAHISHMARI
Block/Municipality : Jalangi
Sub Division : Domkal Post Office : NATIAL
Police Station : Sagarpara Police Station District : Murshidabad
State : West Bengal Pin : 742308

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Photo Identity Proof (Voter Card (EPIC)/ Authority of Certificate Issued): :

Voter Card No (EPIC No) : RVD1439827

Category Details:

Category : UR-Unreserved Whether belongs to Exempted Category(EC)? : No

Disablity Details:

Whether Person with Disability

: No
(40% and above)?

Educational Qualification Details ( Madhyamik or Equivalent ):

Year of Passing : 2008 Name of the State where this Board is situated : West Bengal
Name of the Recognised Board
WEST BENGAL BOARD OF SECONDARY EDUCATION

Highest Educational Qualification Details:

: MASTER OF ARTS
Qualification Year of Passing : 2016
(M.A.)
Name of the Board / Organization
UNIVERSITY OF KALYANI

Declaration:

I have studied the advertising notice thoroughly. I have also gone through the requirements for the post. I do hereby
declare that all statements made in this application are true, complete and correct to the best of my knowledge. In the
event of any information being found false or incorrect or ineligibility being detected before or after or during any stage of
selection process, appropriate action will be taken against me.

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