APPLICATION FORM

To                                                                                                              Dated……….                                                            …………………………………………………………………………………………………………….. ………………………………………………………………………………………………….………….

Sir, I beg to apply for the post of………………………………………………………………………………

Signature of Applicant

1.                   Full name in Capital letters with address ______________________________________________________________________________________________________________________________________________________

2.                   Date of birth : (DD/MM/YYYY) :

3.                   Place of Birth:

 …………………….          …………………..          …...…………….…                 …….……  Village/Town                      Police Station                   District                                 State

4.                Father’s/Mother’s and Husband’s name (in case of married female). ____________________________________________________________________________

5.   Personal Description :

 6. A. Permanent Address in full :                                                  B. Present Address in full : ………………………………………                              ……………………………………...                                 ………………………………………                                         …...…………………………………                                       ……………………………………….                                    ………………………………………

Mobile No. ………………………………………               Email ID .  ………………………………

C. If you have not resided at the above address continuously for the last four years, please give the others address where you have resided during the period.

From:                                              To:                                                                               Address: .…………………………          …….………………………….                    ……………………………….. …………………………...        ………..………………………                    ………………………………..

7. Reference :

Name and address of two responsible in your localities who would be prepared to Vouch ____________________________________________________________________________A.                                                                                     B.

……………………………………………                    ……………………………………………                      ……………………………………………                    …………………………………………...         ……………………………………………                    ……………………………………………                              

8. Are you a Citizen of India ? if so, how ? ( copy of Citizenship certificate should be enclosed where necessary):.………………………………………………………………………………………………

9. Educational and qualification : (please attach copies of certificate Mark sheet etc):

10. Community :

(a) State your Religion:                        (b) Are you a member of Schedule Caste Schedule

                                               Tribe ? Answer ‘yes’ or ‘No’.  If  ‘Yes’ give particulars  

                                                                    supported by a         certificate (copy to be enclosed).

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

 11. Present occupation if any :                         12. Previous appointment held, if any

……………………………………………….                 ………………………………………….

………………………………………………..                 ………………………………………….

12. Number of years of work experience :

13.  Are you a temporary/retrenched personal of a Temporary Department of Government of

Meghalaya (Answer ‘Yes’ or ‘No’ if ‘Yes’ give particulars).

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

Signature

Note : Particulars are to be filled in below the column in the space provided