APPLICATION FORM FOR ADMISSION TO THE RECRUITMENT EXAMINATION ... Date ______ Bank/Post Office. 11. Have you ever been d
ARUNACHAL PRADESH PUBLIC SERVICER COMMISSION ITANAGAR APPLICATION FORM FOR ADMISSION TO THE RECRUITMENT EXAMINATION FOR THE POST OF ASSISTANT ENGINEER (ELECTRICAL)’ 2016 Paste here firmly your FORM NO ___________ (For official use) Important instructions 1. Fill the box in Capital letters only. 2. Write with ball pen in the squares. Leave one box gap. 3. Paste your recent colour photograph in the space provided, one on the application form and other on attendance sheet. All the photographs should be self attested on front side. 4. Enclose supporting documents against Column No.5, 6, 8, 9. 5. All documents should be self attested or attested by Gazetted Officer with proper seal. 6. Applications of those candidates who do not follow the above instructions will be rejected.
recent color passport size photograph duly self-attested on the front side. (Do not sign on the face)
.
1. NAME OF APPLICANT(Give one BOX gap between First/Middle/Surname)
2. FATHER’S/HUSBAND’S NAME
3. POSTAL ADDRESS FOR COMMUNICATION (With State & PIN No.)
4. PERMANENT HOME ADDRESS (With District Headquarter)
___________________________________________
___________________________________
___________________________________________
___________________________________
___________________________________________
___________________________________
____________________________________________
___________________________________
Tel/Mobile No. ______________________
Tel/Mobile No._______________
PIN
PIN
5. DATE OF BIRTH
Day
Month
Year
(as per Matriculation or equivalent examination Certificate issued from Board/University.)
Cont..to page-2
Page-2
6. EDUCATIONAL QUALIFICATION
:
(Attach certificate & marksheet from Matriculation Onwards) Final Year Graduate Post Graduate
Degree in (mention Trade/Category)
(Tick whichever is applicable). In case of final year candidate, proof of appearing the examination issued by the competent authority to be enclose).
APPLICATION FEE : (enclose DD/IPO) For those form other than obtained from Commission’s Office “Deposited in the form of _________________(Demand Draft/Indian postal Order) which ever is applicable to the tune of
`________ (in figure)__________________________________
DD/IPO No. ____________________ Date _____________ Bank/Post Office ___________________
11.
Have you ever been debarred by Union/ State Service Commission, Yes No (a) Date of debarment (b) Period of debarment
DECLARATION I hereby declare that the statement made by me in this application is complete and correct to the best of my knowledge and belief. I have carefully gone through the advertisement and conditions laid down thereof and also hereby undertake to abide by them. In the event of any information being found false or incorrect before, during and after this examination, the Commission can take action leading to cancellation of my candidature at any stage.
Place: Date:
Signature of the candidate in full with date.
ARUNACHAL PRADESH PUBLIC SERVICE COMMISSION ITANAGAR ATTENDANCE SHEET FOR RECRUITMENT TO THE POST OF ASSISTANT ENGINEER (ELECTRICAL)’2016 NAME OF THE CANDIDATE………………………………………………………………………….(to be filled by candidate) ROLL NO ………………………………………………….. ( For official use)
Paste here firmly your recent color passport size photograph duly self-attested on the front side.
Specimen Signature of the Candidate in full
(Do not sign on the face)
TO BE FILLED UP IN THE EXAMINATION HALL
Sl. No.
Subject and paper
Candidate’s Signature with date
Invigilator’s Signature
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VIVA-VOCE N.B: Candidate’s signature on attendance sheet in the exam hall must be identical with his specimen Signature already appended above.
