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Please read the instructions provided on Page No.-3 before filling up the Nomination form: -
Course Title: __________________________________________________ Course Code: ____________
1.
First Middle
Last
Name in English:
Name in Hindi:
2. Father’s / Spouse’s Name:
Service / Cadre & Date of joining /
3. 4.
Grade/Rank : last promotion:
5. Pay Band: 6. Grade Pay /
Scale of Pay:
7. Gender: 8. :
Date of Birth
Details of the Sponsoring Authority (All fields are mandatory)
Name:
Designation:
Complete Postal Address
(with Pin code):
!"! # $: -
% #& : __________________________________________________ : ____________
'&(): ________________________ ________________________ '
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