APPLICATION PRFORMA FOR ENGAGEMENT OF RETIRED INDIAN FOREIGN SERVICE OFFICIAL AS CONSULTANT (INTERNATIONAL RELATIONS) IN PRASAR BHARATI SECRETARIAT AS PER CIRCULAR ADVERTISEMENT NO.A-10/016/44/2015-GA_DATED ___.07.2015

1. / Name of the positionapplied for / :
2. / Name of the Applicant in full (in Block letters) / :
3. / Father’s/Husband’s Name / :
4. / Address for Correspondence / :
5. / Landline No. / :
6. / Email ID / :
7. / Mobile No. / :
8. / Date of Birth / :
9. / Date of superannuation from Central Government service / :
10. / Designation of post at the time of superannuation / :
11. / Last pay drawn/ emoluments (in Rupees) / :
12. / Pay Band and Grade Pay from which superannuated / :
13. / Monthly pension (in Rupees) as per PPO / :
14. / PPO No. (Please enclosed self-attested copy of PPO) / :
15. / Educational Qualification (from Matriculation onwards) / :
16. / Professional Qualification / :
17. / Experience / :

(Please attach separate sheet is space below is insufficient)

Name of the
Organization / Post held/
Designation / From / To / Pay Bandand Grade Pay
(in Rs) / Nature of
Duties
18. / Proficiency in Computer/IT, if any
(please specify the level of accomplishment) / :
19. / Any other relevant information, if any, in support of your suitability for the said engagement. Attach a separate sheet if necessary. / :

DECLARATION

I solemnly declare that the above particular are true and correct to the best of my knowledge and belief, no part of it is false and nothing material has been concealed therefrom. I also understand that my candidature to the post applied for / contractual engagement is liable to be cancelled/ terminated, if at any stage it is found that the above information is false or incorrect or misleading.

Place:______

Date: ______

(Signature of the Applicant)

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