The Workshop Personnel Officer

EASTERN RAILWAY

(APPLICATION FORMAT)

UR / SC / ST / OBC / Ex-SM / PHP

(PLEASE TICK THE RELATED B0X)

The Workshop Personnel Officer

Eastern Railway/Kanchrapara

Kanchrapara Workshop

Sealdah Division

Option (Please tick the appropriate Box)

(Only option for Sealdah or Kanchrapara to be indicated)

Applications for Engagement of Act Apprentices under the Apprenticeship Act 1961 and Apprenticeship Rules 1962, in reference to the Employment Notice No.01/2012-13/KPA.

(For Office use only)

Serial No…………………………………….. Accepted/Rejected………………………

Roll No……………………………………… Trade Desired……………………………

(In Block letter)

(To be filled in by the candidate in his/her own handwriting)

TRADE APPLIED FOR……………….

Paste your recent
Passport size Black & White Photograph signed across top of the photograph & duly attested by a Gazetted Officer.

01.Name in full:…………………………………………………………..

((IN BLOCK LETTERS)

02.Father’s Name (Sri/Late)……………………………………………………

& Occupation………………………………………………………………

03.Nationality…………………………………………………………………

04.Religion ……………………………………………………………………

05.Date of Birth (In Christian era)In figure……………………………………

(to be supported by the documents duly attested)

( In Words ) …………………………………………………….

………………………………………………………………………………

06.Details of Postal Order attached

No of I.P.O / Dated / Value (Rs) / Name of issuing Post Office

07.Present Address for Communications(IN BLOCK LETTERS) :-

……………………………………………………………………………………………………………

08.Nearest Railway Station: ……………………………………………………………………………….

(According to Present Address)

Contd….P/2

………….P/2………..

09.Permanent Address (IN BLOCK LETTERS)

……………………………………………………………………………………………..

………………………………………………………………………………………………

10.Whether belonging to SC/ST/OBC: ………………………………………………………

if yes, then

a)Community/Sub-Caste : ………………………………………………………..

b)Caste Certificate issued by :

(tobesupportedbydocumentsdulyattested)

11.Whether Physically Handicapped: ……………………………………………………………..

if so, indicates nature of disability &

Percentage of disability)

12.Whether a Ex-Serviceman: ………………………………………………………………………

( if so indicate details of Ex-Serviceman status)

13.Educational & Technical Qualification :

( to be supported by documents duly attested )

Sl.
No / Examination Passed / EducationalAuthority Board/University / Name of the
Educational
Institute / Year of Passing / Percentage of Marks

14.Name of the Employment Exchange: ……………………………………………………………………….

Registration No & Date ………………………………………………………………………..

15.Two Personal Marks of Identification a)………………………………………….

b)…………………………………………

16.No.of enclosures (Including I.P.O): ………………………………………………..

17. DECLARATION; -

i) I do hereby declare that all statements as mentioned in this application are true, complete & correct to the best of my knowledge and belief. I understand that in the event of any particulars or information given above being found false or incorrect my candidature will liable to be rejected.

ii) I, also understand fully that the obligation under Apprentice Act (1961, on the part of Railway is to provide me with training only in the allotted trade and not to absorb/provide with employment in the Railways on completion of my training and thus I have no claim for employment as such.

(Signature of the Candidate in full)

(L.T.I of the Candidate) (In Printer’s Ink)

Place:

Dated:

EASTERN RAILWAY

Paste your Recent Passport Size Photograph signed across at the top duly attested by a Gazetted Officer

KANCHRAPARA WORKSHOP

CALL LETTER

(ENGAGEMENT AS ACT APPRENTICE TRAINING)

Notice No.01/2012-13/KPA

(TO BE FILLED BY THE APPLICANT IN HIS OWN HANDWRITING)

Name of the Candidate : ……………………………………………

(IN BLOCK LETTERS)

Father’s Name (Sri/Late):…………………………………………….

Address for communication: ……………………………………………..

with P.S & nearest Railway Station……………………………………………

……………………………………………

(TO BE FILLED IN BY THE OFFICE)

Roll No.______

You are directed to appear for verification of original testimonials and physical fitness at the venue, date and time specified below.

Venue : ………………………………………….

Date………………………………. Time ……………………………….

for Chief Works Manager,

Eastern Railway/Kanchrapara

FREE RailwayPass for SC/ST candidates only (Authority Rly Board’s Circular No.E (NG)/11/83/RSC/14 dated 27.3.1984). On production of this call letter you are entitled to travel free by Rail in 2nd Class from______

Station to ______Station and back. The outward journey should commence not before______and return journey should be completed before______.

for Chief Works Manager,

Eastern Railway/Kanchrapara