ABCDEFGHIJKVWXYZ
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 Government of India
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 Department of Atomic Energy
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 General Services organisation
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PROFORMA FOR APPLICATION
(LOCUM BASIS)
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APPLICATION FOR THE POST OF
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1Advertisement No.GSO/03/2022
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2Full Name (in Block Letters- as per SSC/HSC Certificate)
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3Name of Father / Spouse
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4Date of Birth (DD/MM/YYY)
(in Christian era) 		Age -
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5Gender
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6Marital Status
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7Whether the applicant belongs to SC/ ST/OBC/GEN/EWS (Indicate the name of the Caste / Community)
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8Address in block letters
(with Pin Code & Phone No.) 		CORRESPONDENCEPERMANENT
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Door No, Street
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City
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State
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Pin Code:
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Email:
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Mobile No.Alternate Mobile No.
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Aadhaar No.
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9Are you under Contractual obligation: to serve in Central / State Govt./ Public Sector undertaking / Autonomous body.
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10Educational/Technical Qualifications: (from SSC/SSLC onwards)
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Examination passedName of Course & UniversityYear of passingMarks securedMaximum Marks% of
Marks		Duration of the Course
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SSC/SSLC-
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ITI / Certificate of Course etc.-
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HSC-
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Diploma-
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Bachelor’s Degree (UG)-
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Master’s Degree (PG)-
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Other Qualification-
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-
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-
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 Note: If you are pursuing any higher studies please give the details.
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11Details of Experience (List most recent employment first)
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PeriodDuration
(in years)		Post HeldName & address of the employerPermanent / TemporaryReasons for leaving
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From
(DD/MM/YYYY)		To
(DD/MM/YYYY)
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12Any other information you wish to add:
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DECLARATION
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 I hereby declare that the details given above are correct to the best of my knowledge and belief. In case any information given above is found to be false, action as deemed fit may be taken by GSO. I know that insufficient proof of documents will be liable for rejection of my application.
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Place:
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Date: Signature of the Candidate
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