APPLICATION FOR APPOINTMENT ON CONTRACT BASIS FOR THE POST OF_____________ 1. Name of the Candidate (in Block Letters) : 2. Father’s/Husband’s Name : 3. Date of Birth (as per SSC records) : 4. a) Qualifications. Academic and Technical (from SSC onwards) (Attested Photostat in support of qualifications With marks memos) Qualification Name of the Total Marks %age of Year of With Institution and marks Secured Marks Passing group/Branch Board/University secured (b) Higher Qualifications (M. Phil/ PhD/NET or SLET/MA/M. Ed.,/MBA, etc.) Name of Name of Marks %age of Year of Branch the the Secured Marks Passing Degree Institution secured Note: - The candidates who possess the provisional certificate at the time of applying itself shall be eligible to apply. Those who are pursuing higher studies shall not be considered to be possessing higher qualifications unless possess the provisional or original certificate as on the date of submission of application. 5. Experience (copy of experience certificate shall be enclosed): Sl. No. Name of the Period of Reference Organisation & Service Service in person address Address with Years and and contact From To Phone. No months number 6. Community SC/ST/BC-A/B/C/D/E :
APPLICATION FOR APPOINTMENT ON CONTRACT BASIS FOR THE POST OF_____________ 1. Name of the Candidate (in Block Letters) : 2. Father’s/Husband’s Name : 3. Date of Birth (as per SSC records) : 4. a) Qualifications. Academic and Technical (from SSC onwards) (Attested Photostat in support of qualifications With marks memos) Qualification With group/Branch Name of the Institution and Board/University Total marks Marks Secured %age of Marks secured Year of Passing (b) Higher Qualifications (M. Phil/ PhD/NET or SLET/MA/M. Ed.,/MBA, etc.) Name of the Degree Name of the Institution Marks Secured %age of Marks secured Year of Passing Branch Note: - The candidates who possess the provisional certificate at the time of applying itself shall be eligible to apply. Those who are pursuing higher studies shall not be considered to be possessing higher qualifications unless possess the provisional or original certificate as on the date of submission of application. 5. Experience (copy of experience certificate shall be enclosed): Sl. No. Name of the Organisation & Address with Phone. No Period of Service Service in Years and months Reference person address and contact number From To 6. Community SC/ST/BC-A/B/C/D/E :
2016-17SCWDC&SCWJC.docx