application form for the post of general manager -...
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Application form for the post of General Manager (on Deputation)
Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Father's name :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Enclose Certificate)
Present Post :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Parent department :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Officer & address- competent to
provide NOC :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Category (Please Tick) General/OBC/SC/ST
i Service history :-
(1) Date of first posting :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(2) Designation of first posting :. . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
(3) Present post :. . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
(4) Date of posting at present :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(5) Present pay scale :. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(6) Basic pay Rs. :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(7) Total length of service (In year) :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(8) For AE, length of service as AE (In year) :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(9) Total service in field (In year) :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(10) Home District :. .. . .. . . . . . . . . . . . . . . . . . . . .
ii NOC of Department :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iii Educational Qualification :- (Enclose self attested certificates)
Post Graduate / Graduate Degree / Diploma / Other qualification (mention)
1- % Marks obtained in Graduation :. . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . .
Marks
iv Details of service :-
From To Designation Details of work
done
Place of posting:
Department/Field
4
Details of any TWO construction works, which have been supervised by you and would like to
mention:-
Designation Period from - to Details of work executed Approx. cost of executed
work in Rs Lakhs
v- Present place of posting & Designation :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
vi- Present address, Telephone, Mobile no. :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
vii- Permanent address :. . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Telephone no.: . . . . .. . . . . . . . . . . . . . . . . . . . .
Viii – Preference for Posting : Head Office Bhopal / Field
Declaration
I hereby declare that neither any Departmental/EOW or Lokayukt enquiry is pending against
me nor any major penalty was ever imposed on me. I also declare that court case of any nature is not
pending against me. Information given by me is true to the best of my knowledge & belief. My selection
may be cancelled and suitable action may be taken, if information furnished by me is found incorrect
Signature of applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Name of applicant: . . . . . . .. . . . . . . . . . . . . . . . . . .
.Date :. . . . . . .. . . . . . . . . . . . . . . . . . . .
Place :. . . . . . .. . . . . . . . . . . . . . . . . . . .
5
Form to be filled before Interview
for the post of General Manager on Deputation to MPRRDA
Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Father's name :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Parent department (Please Tick) :. RES / PWD / WRD / PHED / MPSEB/Other
Present Post (Please Tick) :. SE / Addl. SE / EE / Addl. EE / AE
Category (Please Tick) General / OBC / SC / ST
i Service details:-
1- Designation of first posting :. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . .
2- Present pay scale Rs. :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3- Basic pay Rs. :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4- Total length of service (In year) :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5- For AE, length of service as AE (In year) :. . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
6- Total service in field (In year) :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7- Home District :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii NOC of Department (Attach copy) :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iii Educational Qualification :- (Please Tick & Enclose self attested certificates)
Post Graduate / Graduate Degree / Diploma / Other qualification (mention)
iv Details of TWO construction works, which have been supervised by you and would like to
mention:-
Designation From To Details of works Place of
posting:
Departme
nt/Field
S. no. -
Form no -
Date of Interview
- -08
6
Declaration
I hereby declare that neither any Departmental/EOW or Lokayukt enquiry is pending against
me nor any major penalty was ever imposed on me. I also declare that court case of any nature is not
pending against me. Information given by me is true to the best of my knowledge & belief. My selection
may be cancelled and suitable action may be taken, if information furnished by me is found incorrect
Signature of applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Name of applicant: . . . . . . .. . . . . . . . . . . . . . . . . . .
.
Date :. . . . . . .. . . . . . . . . . . . . . . . . . . .
Place :. . . . . . .. . . . . . . . . . . . . . . . . . .
.
7
Application form for the post of Assistant Manager on Deputation
Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Father's name :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Enclose Certificate)
Present Post :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Parent department :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Officer & address- competent to
provide NOC :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Category (Please Tick) General/OBC/SC/ST
i Service history :-
1- Date & Designation of first posting :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2- Date & Designation at present :. . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
3- Present pay scale :. . . . . . .. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .
4- Present Basic Pay :. . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .
5- Total length of service (In year) :. . . . . . .. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .
6- Total experience in field (In year) :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7- Home District :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8- Details of DE/EOW/Lokayukt enquiry :. . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .
(if any)
ii Educational Qualification :- (Enclose self attested certificates)
Post Graduate / Graduate Degree / Diploma / AMIE
2- Civil Engineering Degree /Diploma (Encls copy of marksheet)
:. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(i) Year :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(ii) University :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(iii) Percent :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(iv) Class :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3- Other qualification (Encls copy) :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
i. :. . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .
ii. :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iii. :. . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .
iv. :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4- If AMIE (civil) Please enclose marksheet copy :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
iii Details of service :-
Post From To Details of works done Type of experience: Office/
Field
iv- Present place of posting & Designation :.. . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
v- Present Postal address & telephone no. :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
vi- Permanent address :. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . Telephone no.: . . .. . . . . . . . . . . . . . . . . . . . .
Vii – Preference for Posting : Head Office Bhopal / Field
Declaration
I hereby declare that I have submitted a copy of this application to the authorities of my parent
department. I hereby declare that neither any departmental/EOW or Lokayukt enquiry is pending against
me nor any major penalty was ever imposed against me. I also declare that court case of any nature is not
pending against me. Information given by me is true to the best of my knowledge & belief. My selection
may be cancelled and suitable action may be taken if information furnished by me is found incorrect
Signature of applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Name of applicant: . . . . . . .. . . . . . . . . . . . . . . . . . .
.Date :. . . . . . .. . . . . . . . . . . . . . . . . . . .
Place :. . . . . . .. . . . . . . . . . . . . . . . . . . .
9
Form to be filled before Interview for the post of Assistant Manager on Deputation to MPRRDA
Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Father's name :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Present Post (Please Tick) :.
Parent department (Please Tick) :.
Category (Please Tick) : General/ OBC/ SC/ ST
i Service Details :-
Designation of first posting :. . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
2- Present pay scale :. . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3- Present Basic Pay :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4- Total length of service (In year) :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5- Total service in field (In year) :. . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6- Home District :. . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
7- Educational Qualification (Please Tick & Enclose copy of self attested certificates)
Post Graduate / Graduate Degree / Diploma / AMIE
8- Details of ANY TWO construction works, which have been supervised by you & would like
to mention:-
From To Place Name & Brief of work done
Declaration
I hereby declare that I have submitted a copy of this application to the authorities of my parent
department. I nereby declare that neither any departmental/EOW or Lokoyukt enquiry is pending against
me nor any major penalty was ever imposed against me. I also declare that court case of any nature is not
pending against me. Information given by me is true to the best of my knowledge & belief. My selection
may be cancelled and suitable action may be taken. if information furnished by me is found incorrect
Signature of applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Name of applicant: . . . . . . .. . . . . . . . . . . . . . . . . . .
.
Form no -
Date :. . . . . . .. . . . . . . . . . . . . . . . .
Place :. . . . . . .. . . . . . . . .. . . . . . .
Date of Interview
10
Application form
Part A
for the post of
Task Manager (On Contract)
1. Name of the post (Applied for) : …………………………………………………
2. Post code no. : 3 (Three)
(i.e. s.no. of post in advertisement)
3. Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name) (Surname)
4. Father's name : ……………………………………………………………… (Name) (Surname) 5. Permanent address : ………………………………………………………………
………………………………………………PIN………….
6. Present address : ………………………………………………………………
………………………………………………PIN………….:.
(Address proof : Enclosure 1)
7. Date of birth :. . . . /. . ../ . . . . . . . (In words …….. . . . . . . . . . . . . . . . . . . . .)
(Attested true copy of marksheet of Higher Secondary School Certificate Examination /equivalent
examination exhibiting date of birth : Enclosure 2)
8. Age as on 01/01/2014 : …………… Years ………… Months …………. Days
9. Category (Please tick) : Unreserved/ OBC/ SC/ ST
(Attested true copy of caste certificate in case of OBC/SC/ST candidate : Enclosure …..)
10. Home district : ………………………………………………………………
11. Educational qualification details :
(1) Post Graduation : Degree . . . . . .. .. . Specialisation in ……………………….
(2) Graduation : Degree . . .. . . .. . . .Subject …………………………………
(3) Others : Description ……… . .. . .. . . . . . . . . . . .…………………….
12. Service and experience details :
(1) Parent Department : ……………………………………………………………….
(2) Details of organisation : ……………………………………………………………….
Recent coloured
P.P. size photo
graph attested by a
Gazatted Officer
Advertisement No.
20964
dated
28/12/2013
Application form
No ………….
(for office use only)
11
(3) Present Post :. …………………………………………………………….
(4) Present place of posting :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. . . . . . . .
(5) Designation at first posting :. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. .
(6) Present pay scale :. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ……….
(As per present applicable pay rules)
(e.g. pay scale and grade pay in revised pay structure)
(7) Present basic pay :. Rs. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. .
(e.g. pay in pay band + grade pay in revised pay structure)
(8) Experience on present post (as on 01/01/2014) :. . . . . . Years . . . . .Months . . . . . Days.
(9) Field experience on present post (as on 01/01/2014) :. . . Years . . . . .Months . . . Days.
(10) Total length of service (as on 01/01/2014) :. . . . . . ..Years . . . . .Months . . . . . Days.
13. PAN (if available) : ……………………………………..
(Attested true copy : Enclosure . . . .)
14. Cell phone no. : ……………………………………..
(Signature of applicant)
Name of the applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Declaration
I hereby declare that no criminal proceedings of any nature is pending consideration against
me. I further declare that information supplied by me in, the application form and its supplementary parts
and enclosures annexed to it; are true to the best of my knowledge & belief. My selection to the post may
be cancelled and suitable action may be taken, if information furnished by me shall be found false or
incorrect at any point of time in future.
(Signature)
Name of the applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Encl – Part B,C and D of the application
along with enclosure 1 to ……….
Date :. . . . . . .. .
Place :. . . . . . .. .
12
Part B
Post : Task Manager (On Contract)
1. Name of the post (Applied for) : ……………………………………………………………….
2. Post code no. : 3 (Three)
(i.e. s.no. of post in advertisement)
3. Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . (Name) (Surname)
4. Father's name : ……………………………………………………………… (Name) (Surname) 5. Present address : ………………………………………………………………
………………………………………………PIN………….:.
(Address proof : Enclosure 1)
6. Date of birth :. . . . /. . ../ . . . . . . . (In words …….. . . . . . . . . . . . . . . . . . . . .)
(Attested true copy of marksheet of Higher Secondary School Certificate Examination /equivalent
examination exhibiting date of birth : Enclosure 2)
7. Age as on 01/01/2014 : …………… Years ………… Months …………. Days
8. Category (Please tick) : Unreserved / OBC / SC / ST
(Attested true copy of caste certificate in case of OBC/SC/ST candidate : Enclosure …..)
9. Home district : ………………………………………………………………
10. PAN (if available) : ………………….
(Attested true copy : Enclosure . . . .)
(Signature of applicant)
Name of the applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Advertisement No.
20964
dated
28/12/2013
Application form
No ………….
(for office use only)
13
Part C
Post : Task Manager (On Contract)
1. Name of the post (Applied for) : ………………………………………………………………
2. Post code no. : 3 (Three)
(i.e. s.no. of post in advertisement)
3. Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . (Name) (Surname)
4. Father's name : ……………………………………………………………… (Name) (Surname) 5. Educational qualification details :
(1) Post Graduation : (i) Degree . .. . .. . .. . . Specialisation in ……………
: (ii) Name of institution
: (iii) Year of passing
: (iv) Percentage of marks/CGPA
(Enclosure…….)
(2) Graduation : (i) Degree . .. . . .. . . .. Branch ………………………
: (ii) Name of institution
: (iii) Year of passing
: (iv) Percentage of marks/CGPA
(Enclosure…….)
(3) Others : (i) Description …………………………
: (ii) Name of institution
: (iii) Year of passing
: (iv) Percentage of marks/CGPA
(Enclosure…....)
(Signature of applicant)
Name of the applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Advertisement No.
20964
dated
28/12/2013
Application form
No ………….
(for office use only)
14
Part D
Post : Task Manager (On Contract)
1. Name of the post (Applied for) : ………………………………………………………………
2. Post code no. : 3 (Three)
(i.e. s.no. of post in advertisement)
3. Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . (Name) (Surname)
4. Father's name : ……………………………………………………………… (Name) (Surname)
5. Service and experience details :
S.
No.
Name &
full
address of
employer
Designation Brier
description
of work
Salary
(In Rs.)
Period of
employment
At first
posting
As on
today From To
6. Field experience on present post (as on 01/01/2014) :. . . Years . . . . .Months . . . Days.
7. Total length of service (as on 01/01/2014) :. . . . . . ..Years . . . . .Months . . . . . Days.
(Signature of applicant)
Name of the Applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Advertisement No.
20964
dated
28/12/2013
Application form
No ………….
(for office use only)
15
Contractual Services For TASK MANAGER (on Contract) Applications are invited on prescribed form for One Task Manager on Contract at
MPRRDA Head Quarter, Bhopal. The consolidated remuneration will be Rs. 39000/- per month. Casual
leave for 13 days, medical leave for 15 days is admissible, but perks/benefits such as HRA, CCA, Medical
re-imbursement are admissible.
1. Educational and other qualification :
Bachelor Degree in Civil/Mech/IT Engineering from recognized University with two years
full time MBA/PGDBM in Rural Development/Rural Management/Finance/IT/Operations
from Recognized institutions.
Desirable : Ecperience in Rural Development Work, skilled in Hindi & English both
spoken & written, fair working with Computer Specially well conversant with MS office.
2. Age limit : Not exceeding 40 years as on 01-01-2014
3. Duties of Responsiblities :
a. Responsible for policy formulation in Rural roads, rural housing, habitate development.
b. Monitoring, evaluation, guidance & control of the program in headquarter & in the
field.
c. supervising the work of General Manager in the field.
d. Co ordinate with other departments ofr necessary clearances for construction of road &
allotment of land in Rural Housing Mission.
e. Responsible for all IT application, the e-governace & m-governance modules.
f. Reporting, analyzing & co ordinating with central government for release of fund for
the scheme.
g. Co ordinating with MFI's/Financing institutions/Banks for loans etc.
Period of Job : The period of contract will be one year only and it can be
extended/shortened, if required by the authority.
4. No TA/DA will be paid for appearing for interview. The selected Candidate will have to
sign an agreement with the authority.
5. How to apply and conditions :
a. All applications must be addressed to 'The CEO, MP Rural Development Authority,
Block 2, 5th Floor Paryavas Bhavan, Arera Hills, Bhopal - 462013 and submitted in an
envelop super scribed "Application for the post of Task Manager" by Registed Post.
b. Call letters ofr interview shall be issued subsequently.
c. The interview will be held at Bhopal
d. Incomplete application and applications received after the last date will be rejected. No
interim correspondence will be entertained.
e. The last date for receipt of application is 20-01-2014
Merely fulfilling the minimum prescribed qualifications will not vest any right on a
candidate being called ofr interview. Since it may not be possible to call all the
candidates for interview, the applications will be shortlisted for the purpose. The
decision of CEO, MPRRDA will be final. The Authority will not entertain any
correspondence in this respect.
NOTE : Application form can be Downloaded form the website of the Authority i.e.
www.mprrda.com
General Manager (Admn)
16
Application form for the post of Assistant Manager-IT (on Contract)
1. Name of applicant :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Father's name :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Date of Birth :. . . . . . .. . . . . . . . . . . . . . . . (Age as on 01.01.2014 ). . . . .. . . . . . . .
(Enclose Certificate)
4. Home District :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. Category (Please Tick) General/OBC/SC/ST
6. Educational Qualification :- (Enclose self attested certificates)
7. MBA/MCA/BE in computer science or IT
Sl.No. Name of Exam Name of Institution / Board
Year Percentage Div. /
Grade
1 10th
2 12th
3 Graduation
4 MBA/MCA/BE in
computer science or IT
5
8. Details of Expereince :-
S.No. Details of works Post held Name of
Organisation
From To Total
Years
Monthly
Salary
1 MIS Development
Experience
2 GIS application
experience
3 Web application
experience
4 RDBMS
experience
5 Networking
experience
6 Hardware
Photogragh
17
experience
7 Other experience
9. Present Postal address & telephone no./Mobile No. :. . . . . . .. . . . . . .... . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Permanent address :. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Telephone no/Mobile No. .: . . . . . .. . . . . . . . . . . ……………. . . . . . . . . .
Declaration I hereby declare that neither court case of any nature is not pending against me nor any
major penalty was ever imposed against me. Information given by me is true to the best of
my knowledge & belief. My selection may be cancelled and suitable action may be taken.
if information furnished by me is found incorrect.
Signature of applicant: . . . . . . .. . . . . . . . . . . . . . . . .
Name of applicant: . . . . . . .. . . . . . . . . . . . . . . . . . . .
Date :. . . . . . .. . . . . . . . . . . . . . . . . . . ..
Place :. . . . . . .. . . . . . . . . . . . . . . . . . . .
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