7/18/2019 Burn Standard

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a) Name of the post applied for :(b) Name :(c) Father's/Husband's Name :(d) Address - Permanent & Correspondence :(e) Phone/obile No! :

(f) "mail #$ :(%) A%e & $ate of irth (ith supportin% document) :(h) eli%ion :(i) Caste (Certificate in case of C/*/+C) :(,) Phsicall Handicapped (ith supportin% document) :(.) arried or in%le :(l) "ducational and Professional ualifications be%innin% ith atriculation/e0ui1alent alon% ith ear ofpassin%2 3 of mar.s2 di1ision/class obtained2 sub,ects ta.en indicatin% oard/4ni1ersit (elf-attested$ocuments to be enclosed) as per the format belo : :

"ducational andProfessional ualification

ub,ectsta.en

Name of theoard/4ni1ersit

5ear ofPassin%

3 of mar.sobtained

$i1n!/Class

 

(m) Details of experience including names of organizations, position held/nature of dutieswith duration along with basic pay/allowances drawn mentioning pay scales (previous and

present) (enclosing supporting documents) as per the following format and last pay drawn

certificates : 

Name of+r%anisation

Positionheld

*enure of ser1iceNature ofduties

Pa cale2 asic Pa & Alloances dranFrom

$$//55*o$$//55

 

Date : Signature of the andidate

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