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SANT GADGE BABA AMRAVATI UNIVERSITY Funded by Tribal Research & Training Institute, Pune

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COMPETITIVE EXAMINATION GUIDANCE CENTRE (UPSC) APPLICATION FORM Name of Candidate – Mr./Miss/ Mrs. ____________________________________________ Name of Father/ Husband - Mr./Shri _____________________________________________ Permanent Residential Address - ________________________________________________

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___________________________________________________________________________ District - _______________________ Pin - ______________ Date of Birth - _____________________________________

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Mobile No. - ______________________________________ Alternate Mobile No. - ______________________________

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Email. - __________________________________________

Aadhar Card No: ___________________________________

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Caste & Category (attach Xerox) - ____________________ Academic Performance (From Secondary School Certificate Onwards):

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Name of Examination

Board/ University

Year of Passing

Subjects Appeared For

Marks Obtained out of Total

Percentage Marks

S. S. C.

H. S. S. C

Have you qualified in any other competitive examination? If yes, please specify: 1)___________________________ 2)_____________________ 3) ____________________ 4)___________________________ 5)_____________________ 6)_____________________ Check list of documents to be attached (Attested Xerox Copies) : i) ii) iii) iv) v) vi)

Aadhar Card Caste Certificate Caste Validity Certificate Degree Certificate. Final Year Degree Mark Sheet. Competitive examination you have passed, if any.

This is to certify that all information provided above is true to the best of my knowledge. I shall be held responsible if it is proved that there is misrepresentation and action can be taken against me. Signature of Candidate Date :(Name-

)