(Self attested copy of Caste Certificate to be enclosed). 10. ... Instrumentation Engineering / Computer Science ... b)
CORPORATION OF CHENNAI, RIPON BUILDING, CHENNAI - 600 003. APPLICATION FOR THE POST OF ASSISTANT ENGINEER (MECHANICAL) / (CIVIL) / (ELECTRICAL) & SANITARY INSPECTOR APPLICATION FOR THE POST OF Affixed Photo should be attested by the gazetted officer
1.Name in full (Block Letters)
2.Father’s / Husband’s Name
3.Gender
Male
Female
Third Gender
(Tick the relevant box)
Married
4.Maritual Status
Unmarried
(Tick the relevant box)
5.Full Postal Address with Mobile No. & email-id a) Permanent Address: ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Pincode: District:
Mobile No:
email-id:
b) Address for correspondence ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Pincode: District:
Mobile No:
6.Nationality :
email-id:
Religion :
7. a) Date of Birth :
b) Age : D D/ M M/ Y Y Y Y
(Self attested copy of High School Certificate showing Date of Birth must be enclosed)
8.a) Mother tongue : (Please mentioned if Tamil is not mother tongue) b) Second Language in School :
Widow
9.Category [SC(A)/SC/ST/MBC/BC/BC(M)/OC] : (Self attested copy of Caste Certificate to be enclosed) 10.EDUCATIONAL QUALIFICATION (Self attested copy of all Educational Qualifications to be enclosed) Sl.No.
Qualification
1.
SSLC / MATRIC
2.
HSC
Register No.
Year of Passing
Marks, Grade obtained with class Grade % Class
Nam of the Institution
Marks, Grade obtained with class
Name of the Institution
11.PROFESSIONAL / TECHNICAL QUALIFICATION (Self attested copy of Certificates as Proof) Sl.No.
Qualification
Register No.
Year of Passing
Grade
%
Class
1.
2.
12. a) Wheather Ex-servicemen
b) If yes, please furnish the detail and enclosed self attested copy of discharge certificate Date of Entry in Armed Forces
Note : Stage of the case at the time of applying, Nature of the criminal charge, if acquitted on the date of this application date of judgement should be given. (Tick the relevant box)
Section of Law
Pending Stage of Case
YES
NO
Acquitted
YES
NO
Date of Acquitted
D D
M M Y
Y Y
Y
PARTICIPATION IN POLITICAL In agitation
YES
NO
As member of Political Organisation
YES
NO
Candidate in Election
YES
NO
Note :
Qualification for the post : 1) Assistant Engineer (Mechanical) : A degree in Mechanical Engineering / B.Tech (Mechanical ) / Auto Mobile Engineering /Mechatronics Engineering OR A pass in Sections A and B of the Institution Examinations (A.M.I.E) under Mechanical Engineering Branch
OR A pass in Sections A and B of the Institution Examinations (A.M.I.E) under Civil Engineering Branch.
3) Assistant Engineer (Electrical) : A Degree in Electrical Engineering/ Electronics and Communication Engineering / Information Technology / Instrumentation Engineering / Computer Science OR A.M.I.E under Electrical Engineering Branch. (Recruitment for the Degree in Electrical & Electronics Engineering Degree in Electronics and Communication Degree in Instrumentation Engineering Degree in Information Technology / Degree in Computer Science) -
14 Vacancies 5 Vacancies 2 Vacancies 2 Vacancies
4) Sanitary Inspector a) Must have minimum qualification of B.Sc. Degree (main subject Chemistry) from the Recognized Institution approved by Government. b) P.G. Diploma in Sanitary Inspector course conducted by the Institutions recognized by the Government. c) Certification in Computer course.
Check list of Enclosures (Tick the relevant Column)
Sl.No.
Documents
Yes
1.
Passport size photos (Colour) 3 Nos (1 pasted on application form, 1pasted on hall ticket and 1to be enclosed with application
[SC(A)/SC/ST/MBC/BC/BC(M)/OC] – in prescribed proforma 5.
No Objection Certificate (in case of Departmental candidates)
6.
Differently abled persons Certificate in prescribed proforma for Employment in State Government
7.
Discharge Certificate (in case of Ex-servicemen)
8.
Whether all above documents / certificates are self attested
Signature of the Candidate Date : Place:
DECLARATION I hereby declare that all the statements made in this application are true and correct to the best of my knowledge and belief. In the event of any information being found false / incorrect or ineligibility deducted before or after the written test / certificate verification or even after appointment, my candidature / appointment will stand automatically cancelled.
