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APPLICATION FORMAT FOR RECRUITMENT
(ONE FORM FOR ONE POST ONLY)
1.
Post Applied For
:
---------------------------------------------------------
APPLICATION FORM AND REGISTRATION
FEE OF 900/- TO BE PAID ONLY
ON SUBMISSION OF THE FORM PLEASE
INSIST ON RECEIPT OF THE APLICATION FEE.
2.
PASTE RECENT
PASSPORT SIZE
PHOTOGRAPH
Personal Details
a) Name
b) Father’s Name/Husband’s Name
c) Date of Birth
d) Age as on today
e) Sex
f) Marital Status
g) Passport Details (No. &
h) Place of Issue Passport
Valid upto)
i) Category (SC/ST/OBC/GEN)
3.
Nationality
Address for Correspondence
Permanent Address
Address
Tel. No.
Mobile No.
E-Mail
(Signature of Candidate)
KISAN SEVA KENDRA,KISAN BHAWAN ,SECTOR-41,CHANDIGARH,PINCODE-160036 Email:- [email protected]
Website: kisansevakendra.org, Phone:91+8745095258
4 (a).
Sl.
Academic Qualifications in descending order
Examination Passed
No.
Professional Qualifications
Sl.
No.
Examination Passed
Sl.
No.
Year of Passing
Institution/University
4 (b).
4 (c).
Name of
Name of
Institution/University
% of Marks/
Specialization
Grade
Year of Passing
% of Marks/
Grade
Specialization
Certification (if any)
Course/ Certification
Field
Name of
Institution/University
Year of Passing
(Signature of Candidate)
KISAN SEVA KENDRA,KISAN BHAWAN ,SECTOR-41,CHANDIGARH,PINCODE-160036 Email:- [email protected]
Website: kisansevakendra.org, Phone:91+8745095258
5 (a)
Employment Records
(Current Employment Record)
Sr.
No.
Organization
5 (b)
Past Experience :
Sr.
No.
Organization
Designation
Designation
Pay Scale(CDA with
grade pay/IDA) or
CTC
Period
From
To
(dd/mm/yyyy (dd/mm/yyyy)
Job Description
Pay Scale(CDA with
grade pay/IDA) or
CTC
Period
From
To
(dd/mm/yyyy (dd/mm/yyyy)
Job Description
(Signature of Candidate)
KISAN SEWA KENDRA,KISAN BHAWAN,SECTOR-41,CHANDIGARH,PINCODE-160036,Email:- [email protected]
Website: kisansevakendra.org,Phone: +91-8745095258
6
Total Post Qualification Experience in years :
7.
Any other information relevant to the job :
Note :
1. If the sheets above are not sufficient please attach extra sheets, wherever necessary.
2. Mentioned the list of documents attached alongwith the form.
(a)………………………
(b)………………………
(c)……………………….
I certify that the information given above is true and correct.
(Signature of Candidate)