Application Form Annexure 1 : Capital Letters in Own Handwriting
Application Form Annexure 1 : Capital Letters in Own Handwriting
Application Form Annexure 1 : Capital Letters in Own Handwriting
ANNEXURE1
APPLICATION FORM FOR CENTRALISED EMPLOYMENT NOTICE No. PLEASE FILL UP THE APPLICATION IN CAPITAL LETTERS IN
03/2012
OWN HANDWRITING,
except signatures and in places indicated $ where it should NOT be in Capital letters
1.
Common Application for the Preliminary Exam for NTPC Graduate categories
(Commercial Apprentice, Traffic Apprentice, Enquiry Cum Reservation Clerk, Goods Guard,
PASTE (do NOT pin or staple) here your recent colour passport size photograph of size 3.5 cm X 3.5 cm (The color
photograph should not be
Jr. Accounts Assistant cum Typist , Sr. Clerk cum Typist), ASM & Traffic Assistants notified in CEN 03/2012
$
Signature of the Candidate in the above box below in the photograph (NOT in capitals)
2.
CHOICE OF RAILWAY : To be given while submitting detailed application form after declaration of
3.
NAME OF CANDIDATE
SHRI/SMT/KUM
SHRI SMT
5.
UR
*SC
*ST
OBC
b) If OBC please state whether belonging to Minority Community c). If minority , indicate community: 7.
8.
Yes
No
Male
Religion:
Hindu
Muslim
Christian
Sikh
Buddhist
Jain
Parsi
Others
9.
Years
Months
Days
10.
Yes
No
No
Yes
No
If Yes,
VH
OH
HH
No
Qualification (Fill in only those qualifications prescribed for the posts applied for)
Academic``` SSC/ X/ Matric Higher Secondary/ XII / Inter Graduation Post Graduation Others
Qualification
University/Board
Year of Passing
Subjects
Marks%
13.
ADDRESS
Name:________________________________________________________________________
14.
(FOR CORRESPONDENCE)
To SC/ST Candidates)
15. Left Hand Thumb Impression
$
Signature of the Candidate (NOT in capitals)
Of the Candidate in this Box Note: 1) Candidates must fill up their name, father's name and date of birth as indicated in their Matriculation Certificate
2) Candidates should put their full signature at all the places in the same language (English or Hindi)
INFORMATION SHEET
(to be filled in CAPITAL LETTERS only - Signatures should NOT be in Capital / Open letters)
ANNEXURE-2
RAILWAY RECRUITMENT BOARD_____________________ INFORMATION SHEET (For Centralised Employment Notice No. 03/2012 1.
2. 4.
MEDIUM OF EXAMINATION: (Choose any one of the Regional languages of RRB concerned as given in para 15 of Notificaiion. if other than English/Hindi & Urdu) Permanent Address
5.
______________________________________________________________________
______________________________________________________________________ P.O:_____________________City:__________________Dist:____________________
State:________________________________PIN Code:_________________________
6(a).
Amount
6(b).
Are you seeking fees exemption (Yes / No). (i) As an Economically Backward class candidate
(Income certificate to be enclosed as per Annexure 7)
If yes , ( ) tick appropriate box from the following : (iii) As a Female Candidate (iv) As a SC / ST Candidate (v) As an Ex-servicemen (vi) As a Physically Handicapped
Judicially separated/
7.
Are you seeking age relaxation as:( ) Tick appropriate box SC STOBC
J&K Resident
Divorced woman/Widow
ExSM
Railway Employee
8.
Present employment (To be filled by all Railway / Central / State / PSU employees)
Date from,
Date to
9.
Ex-Serviceman (Ex-SM)
Date of Enrolment
Date of attestation
Date of Discharge
Length of Service
10. 11.
a) NO
c) For Life
Documents attached in proof of : Indicate ( ) tick mark in the relevant boxes indicated below
IPO / DD
Community Certificate
Disability Certificate
Economically backward Certificate (Should be in the Letter Head of the issuing authority as per Annexure 7)
Declaration from Visually Handicapped candidates/those candidates whose writing speed is affected by cerebral palsy as per annex-10
12.
Please copy the following declaration in your own handwriting in running hand (NOT in capitals) in the space provided below;
I hereby declare that all the statements made by me in the Application Form and the Information Sheet are true and complete to the
best of my knowledge and belief and nothing has been concealed or suppressed. I also understand that in case, any of my statements is found untrue during any stage of recruitment or thereafter, I shall be disqualified forthwith for the post applied for and I shall also be liable for any other penal action under the extant rules". ('Not filling up the above passage will disqualify you)
$________________________________________________________________________________________________________
_________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________
13.
$
Signature of the Candidate
Place: Date:
(NOT in capitals)