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APPLICATION FORMAT FOR THE POST OF JUNIOR ADMINISTRATIVE ASSISTANT

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(Do not Attach any certificate/marksheet or copy except copy of Caste Certificate in respect of SC & ST candidates claiming concession on Application Fees)
1. / Name ( in Capital letters) / : - / SRI/SMT.
2. / Sex / :-
3. / Father’s/ Mother’s /Husband’s Name / : - / Sri/Smt
4. / Mailing Address (in capital letters) / : -
5. / Category
(GEN/ SC /ST(P)/ST(H)/ OBC/ MOBC / PH) / :-
6. / Date of Birth (According to HSLC/ Matriculation Admit Card/ Certificate) / :-
7. / Exact Age as on 31.08.2011 (Year, months and days) / :-
8. / Amount of Treasury Challan, Treasury Challan No. and Date / :-
9. / Education Qualifications: -
Name of Exam passed (HSLC onwards) / Year of passing / Division/ Class / P. C. (%) of marks obtained / Board / University
. / I hereby declare that all the statements made by me in this application are true and complete to the best of my knowledge and belief and nothing has been concealed or suppressed. I also understand that in case, any of my statements is found false or incorrect during any stage of recruitment or thereafter, shall disqualify me for the post applied for and I shall also be liable for any other action under the extant rules.

Place : -

Date : -

/ Signature of the applicant

Note : Candidates must attach only the following with this application form:

1.  Treasury Challan in Original

2.  Duly signed 2 (Two) copies of passport size photograph (one firmly pasted & other stapled) with candidate’s name clearly written on the back of the photographs in capital letters.

3.  Caste Certificate (Only if the candidate belongs to SC or ST category)

4.  No Objection Certificate in case of Govt./Semi-Govt. Employees.

No other documents or copies of certificates/mark sheets etc. or self-addressed envelope etc. are required to be sent along with the Application Form.