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Name of the Candidate: ………………………………………………………………………………………………………………………………………………………
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Father’s Name: …………………………………………………………………………………………………………………………………
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Annual Income : ………………………………………………………
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Occupation (Business/Service/Retd………………………………………
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Designation:…………………………………………………………….
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Organization: ..………………………………………………………………………
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Mother’s Name : ………………………………………………………………………………………………………………………………………………………………
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Annual Income : ………………………………………………………
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Occupation (Business/Service/Retd………………………………………
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Designation:…………………………………………………………….
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Organization: ..………………………………………………………………………
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Name of Guardian/Local Guardian:………………………………………………………………………………………………………………………………………
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Mailing Address : ………………………………………………………………………………………………………………………………………………………………..
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Phone No………………………………………………….Mobile No………………..………………..Email :………………………………………………………….
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Candidate’s Date of Birth:…………………………………..Sex: Male……..Female…………….Category: Gen……OBC……..SC…….ST……….
(As per Matriculation Certificate)
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Permanent Address: …………………………………………………………………………………………………………………………………………………………..
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City :……………………………………………………………………………..
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Pin Code:……………………………………………………………………………..
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Distt. :……………………………………………………………………………..
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State:……………………………………………………………………………..
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Mailing Address: ………………………………………………………………………………………………………………………………………………………………….
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City :……………………………………………………………………………..
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Pin Code:……………………………………………………………………………..
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Distt. :……………………………………………………………………………..
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State:……………………………………………………………………………..
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Phone No. :……………………………………………………………………
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Fax :……………………………………………………………………………..
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Mobile No. :…………………………………………………………………
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E-mail :……………………………………………………………………………..
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Qualification:
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Degree/Board
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Discipline
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Board/Uni.
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Passing Year
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Passing Marks
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Percentage Obtained
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Marks Obtained
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10th
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10+2
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Graduation
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Post Graduation
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Others
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Work Experience, If any : ……………………………………………………………………………………………………………………………………………………
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(Attach the Certificate) ………………………………………………………………………………………………………………………………………………………
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Written Test : Appeared/Passed: …………………………………… Name of the Agency
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CAT/MAT/Others………………………………………………………………….
(Strike off which is not applicable)
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