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(Deputation) : Annexure-1 Proforma For Application

This document contains a pro forma or application form for a job posting. The application form requests information such as the applicant's name, contact details, education history, employment history, references, and a declaration signing off that all information provided is true. The form is to be sent through the applicant's employer or forwarding authority by the specified deadline.

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SUMIT KUMAR
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709 views2 pages

(Deputation) : Annexure-1 Proforma For Application

This document contains a pro forma or application form for a job posting. The application form requests information such as the applicant's name, contact details, education history, employment history, references, and a declaration signing off that all information provided is true. The form is to be sent through the applicant's employer or forwarding authority by the specified deadline.

Uploaded by

SUMIT KUMAR
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Annexure-1

PROFORMA FOR APPLICATION

1. Advertisement No:
Space for
2. Post Applied for: photograph duly
(DEPUTATION)
signed by the
3. Application Fee details:
candidate

4. Category:
SC/ST/OBC/UR

5. Name (in block letters):


First Name:
Middle Name:
Last Name:

6. Father’s /Husband’s Name:

7. Permanent Address

8. Address for correspondence

Pin code :
Tel. No. & Fax No. with STD Code:
E- mail :
Mobile :

9. Nearest Railway Station:

10. Date of Birth (Date/Month/Year):

11. Age as on: Last date of submission of application


(in Years, Months and Days)

12. Scale of Pay of present post & present


Basic Pay and Total emoluments drawn:
(for employed candidates)

13. Educational Qualifications starting with High School (10th ) :

Sl. Exams Name of the Board/ Year of Subjects Division


No. passed University passing

1
14. Employment details:

Name of the Full Address of Post held Period Pay Level & Nature of duties/
Employer/ Employer/Organization From* - To* Pay experience
Organization Matirx/Pay
Scale

15. The application has to be sent through Employer/Forwarding Authority, so as to reach the
Institute within the deadline. However, an advance copy may be sent to NIH.

16. References: (Name and Designation along with contact address details including fax, email and
mobile)
(i)
(ii)
(iii)

17. Any other relevant information:

DECLARATION

I affirm that information given in this application is true and correct. I also fully understand
that if at any stage it is found that any attempt has been made by me to willfully conceal or
misrepresent the facts, my candidature may summarily be rejected and employment terminated.

PLACE : (SIGNATURE OF THE APPLICANT)

DATE :

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