APPLICATION FORM Duly Filled Application form to be brought at the time of walk-ininterview Category No. Name of category applied for

the

Affix passport size Photograph

A) PERSONAL INFORMATION 1

NAME OF THE APPLICANT (In Full)

2

FATHER’S/HUSBAND NAME

3

COMPLETE PRESENT ADDRESS

4

COMPLETE PERMANENT ADDRESS

5

AGE

6

DATE OF BIRTH

7

SEX

8

MARITAL STATUS

9

LANGUAGES KNOWN

Page 1 of 4

10 Email ID: 11 Land Line Phone Number (optional) 12 Mobile No. 13 ID proof ( Voter ID/Adhaar/PAN Card/Passport/Driving license) B) ACADEMIC RECORD S. Qualification No. 1

Matric

2

10+2

3

Graduation/ Professional Degree/Diploma

4

Post Graduation

Name of the Year of Subjects Board/University passing

Marks obtained & Percentage

C) CERTIFICATIONS (Eucalyptus/VM Ware/ITIL V3 foundation/equivalent) S. Name of the certification No. 1

Year of Passing

Marks Obtained

Grading

2 3 4

Page 2 of 4

D) SOFTWARE, HARDWARE & WEB SKILLS 1

2

Languages (Programming/ Non Programming) DBMS/RDMS

3

Hardware/ Networking

4

Web Tools

5

Others

E) Short write up (Half page) on skills related to category applied for

Page 3 of 4

F) DETAILS OF EXPERIENCE (Last assignment first) Experience shall be counted only for the period after obtaining the essential qualification mentioned in job description of each category. Sr. Organization Job No. and Position Description Held 1

Period

Emoluments

2 3 4 G) Please describe in brief of the roles & responsibilities, job handled and tools used in the last assignment as well as expected remuneration:

Certified that the above mentioned is true to the best of my knowledge and nothing has been concealed. Dated:

Signatures

Place:

(Full Name)

Note: Incomplete application form shall not be accepted.

Page 4 of 4

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