Employment History (From latest to previous)

Mode of Education in Highest Qualification

Employer Name Start Date(MM/YY)

End Date(MM/YY)

Team SizeHandled

Gross Salary perMonth (in Rs.)

Last Designation HeldFunction/Domain/

Role

Full Name (As per Matriculation Certificate)

Position Applied For

Gender Date of Birth(As per Matriculation Certificate)

One visible mark of identification

Email ID

Application ID

Affix Passport SizePhotograph

(3.5 cm X 4.5 cm)coloured

Signature of CandidateFather’s Name Category:

PermanentAddress

CurrentAddress

Total Relevant Exp. in Months

Area of RelevantExperience

EmploymentStatus:

Education Details

Alternate/Land Line Number

Mobile Number

Qualification

10th

12th

Graduation

PG

University/Board InstitutionDegree/Course

Specialisation Year ofpassing

Percen-tage

Medium ofInstruction

Block/City

District

State

City

State

Total Experience in Months

MS Office SkillsAdditionalExperience if any?

Application ID:

Part - A(This form duly filled should reach the HR Agency on or before the last date mentioned in the Advertisement)

(As per Matriculation Certificate)

JEEV KAi Bihar Rural Livelihoods Promotion SocietyCandidate Application Form - Community Coordinator

9999999999

abc@gmail.com

Abc Company

Language Proficiency

English Hindi

Local Language(s) known

Documents EnclosedPlease tick ( ) the documents , Xerox copies of which you have attached with the application form. Copy of the caste certificate is applicable only for candidates applying under reserved category.

Copy of the CasteCertificate

Copy of HighestEducational Certificate

Passport Size Photograph (one Copy)To Affixed to this application sheet Domicile Certificate

To be enclosed To be enclosed To be enclosed To be enclosed

Declaration: I hereby declare that all statements made in this application are true, complete and correct to the best of myknowledge and belief. I understand that in the event of any information being found suppressed/false or incorrect or anyineligibility being detected before or after the examination, my Candidature/ appointment is liable to be cancelled. I know thatmere eligibility doesn’t guarantee a job. Based on application received BRLPS reserves the right to shortlist candidates based onqualification & relevant experience. Signature of the Candidate

Application ID:

Application ID:

Instructions to the Candidate

a. While applying for these posts, the applicant should ensure that he/she fulfils the eligibility and other norms mentioned in the website on the specified dates and thatthe particulars furnished by him / her are correct in all respects. In case, it is detected at any stage of recruitment that a candidate does not fulfil the eligibility normsand / or that he / she has furnished any incorrect / false information or has suppressed any material fact(s), his /her candidature will stand cancelled. if any of theseshortcomings is / are detected even after appointment, his / her services are liable to be terminated.

b. All application forms are generated online and will have pre-printed unique registration numbers. The Community Coordinator application form is also generated online.Based on applicant preference, the entire application form can be filled online or the application form can be printed online and filled offline

a. Part A of the form

i. Photograph:

1. Affix (paste with good quality glue) recent (within last three months) Passport Size colour Photograph 3.5 cm X 3.5 cm) in the designated place in the Application.

2. Full signature of the applicant should be placed within the box provided below the photograph area using ball point pen in blue ink.

3. Signature should NOT be done on the photograph.

4. Photographs affixed in Part A and Part B should not differ in case of any reason.

ii. Address:

1. Pin code in the address column should be in full. Eg; write 800010 instead of 10 only.

iii. Visible Mark of Identification

1. The visible mark of identification is asked for the purpose of cross verification of the applicant in future stages.

2. Applicants are requested to provide any one visible mark from the list below.

a. Visible scar other than from vaccination

b. Visible moles

c. Other visible birth marks if any.

“ ” “ ”

1. Points to be noted before you fill the offline form

2. Points to be noted while filling the application form

REGISTRATION SLIP FOR BIHAR RURAL LIVELIHOODS PROMOTION SOCIETY

(The original of this slip is to be retained by the candidate and will be required

for appearing in all future rounds)

Application ID

Name of Candidate

Gender

Position Applied For

Affix Passport SizePhotograph

(3.5 cm X 4.5 cm)coloured

Note - Candidate to read the instructions carefully before posting the application.

Job Code

Date of Birth

Part - B

Signature of Candidate

JEEV KAi Bihar Rural Livelihoods Promotion Society

Application ID:

4. Documents to be sent to HR Agency.

Check list of Documents to be Sent to HR Agency along with Filled Application Form

Sl.No

1

2

3

4

5

6

7

8

Document Name

Part - A of the filled Application Form

Part - B of the Filled Application Form

Part - C of the Filled Application Form

Passport size 3.5cm width and 4.5cm Height

Passport size 3.5cm width and 4.5cm Height

Highest Relevant Qualification Certificate

Caste Certificate (When applying under reserved Category)

Domicile Certificate (When applying under reserved Category)

Type

Original

Photostat

Original

Photostat

Attested Photostat

Attested Photostat

Attested Photostat

Original

Remarks

Candidates are requested to retain a photo copyof the Page before sending original to Agency

Candidates are requested to retain the originalof the page and send photocopy to agency

Glued to Part-A of the Application Form

Glued to Part-B of the Application Form

Stapled with Application Form

Stapled with Application Form

Stapled with Application Form

Candidates are requested to retain a photo copyof the Page before sending original to Agency

Attestation to be done by a Gazetted Officer with his Name, Sign and Clear Seal, or the Principal of a Government School or College

5. The documents can be sent to the HR Agency through India post, Speed Post, Land or Air Courier as per

applicant preference

a. The envelope should be properly sealed and super scribed with

Name of the position, Application ID, Job code and the Address filled in the block letter.

Category – Gen/EBC/SC/ST/BC

b. The above documents should be stapled with the Application and mail it to the address :

�

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TMI Network, Career Center, 1-8-303/48/12, P.G. Road,SECUNDERABAD-500 003.

3. Candidate should clearly mention the location of the birth mark eg: A mole on right chin , Scar from injury on left hand .

iv. The total experience in Months indicates the candidate experience from the date of Joining in his/her first job till date and the total relevant experience indicates thecandidate having total experience in the area as asked in the job description.

b. Part B of the form.

i. Photograph:

1. Affix(paste with good quality glue) recent (within last three months) Passport Size colour Photograph 3.5 cm X 3.5 cm) in the designated place

2. Full signature of the applicant should be placed within the box provided below the photograph area using ball point pen in blue ink.

3. Signature should NOT be done on the photograph.

ii. The original of this slip is to be retained by the candidate and will be required for appearing in all future rounds

c. Part C of the form (For community Coordinators only).

i. Part C Contains 3 questions

1. All questions have to be answered.

2. Candidates are advised to conduct local research before they go about answering the questions.

3. The answers have to be written in candidate’s own handwriting using blue/black ball point pen.

4. Answers should be written in a legible handwriting without too many corrections.

5. Forms with Illegible answers will be summarily rejected.

a. Completion:

i. Incomplete fields ii. Illegible entries

iii. Non contextual responses in handwritten questionnaire

b. Photos

i. Photograph with seal affixed on it ii. Old faded or group photographs

iii. Black and white photographs iv. Photographs not in the specified size

c. Documents

i. Copy of highest relevant qualification certificate not attached

d. Solicitation:

i. Writing note to HR Agency soliciting support ii. Placement of currency notes or cheques inside the application form.

iii. Attempting to solicit support over the phone by promising favours or money. iv. Any other act that can be construed as solicitationary in nature, direct or indirect.

“ ” “ ”etc

3. Reasons for rejection of Applications

Note: Those candidates who are not attaching caste or domicile certificate will be treated as general candidate.

Instructions

The following three (3) Questions are part of the selection process for the post of Community Coordinators.

Your answers will be rated for clarity and contextuality. Applications with inappropriate response, no response or part response will besummarily rejected.

Q1. Please write about three developmental schemes that are being implemented in your District/Block? (within 100 words)

Q2. Out of the three developmental mentioned above, write three shortcomings and recommendation for improvement in one ofthe projects? (within 150 words).

Q3. Please explain why you are suitable for the position that you have applied for? (within 150 words).

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schemes

Application ID:

JEEV KAi Bihar Rural Livelihoods ProjectCandidate Application Form - Community Coordinator

Part - C(This form duly filled should reach the HR Agency on or before the last date mentioned in the Advertisement)