APPLICATION FOR THE POST OF ______________
Passport Size photograph duly attested by the present employer |
__IN T.R.A.I.
1. Name and Complete Office Address
with Telephone No. (in Block letters) … … …
2. Residential Address with Phone No.
3. Date of Birth (in Christian era) … … …
4. Whether belongs to SC/ST … … …
5. Date of retirement under Central/State Govt. Rules … … …
6. Educational Qualifications … … …
7. Whether Educational and other qualifications
required for the post are satisfied (If any qualification
has been treated as equivalent to the one prescribed
in the rules, state the authority for the same) … … …
| | Qualification/ Experience required | Qualification /Experience possessed by the officer |
Essential | (1) (2) (3) | | |
8. Post held on regular (i.e. substantive) basis and the date
from which held with pay scale
9. Please state clearly whether in the light of entries
made by you above, you meet the requirements of
the post … … …
10. Details of Employment, in chronological order,
enclose a separate sheet, duly authenticated by
your signature, if the space below is insufficient … … …
P.T.O.
Office/Instt/ Post held From To Scale of pay Nature of
Orgn. and basic pay duties
11. Nature of present employment, i.e. adhoc or
temporary or permanent … … …
12. In case the present employment is held on
deputation/contract basis, please state
a) The date of initial appointment … … …
b) The period of appointment on deputation/
contract … … …
c) Name of the parent office/organization to
which you belong … … …
13. Training/Courses attended … … …
14. Additional details about your present employment
Please state whether working under –
a) Central Government … … …
b) State Government … … …
c) Autonomous Organizations … … …
d) Government Undertakings … … …
e) Universities … … …
15. Are you in Revised Scale of pay? If yes, give the
date from which the revision took place and also
indicate the pre-revised scale
16. Total emoluments per month now drawn … … …
17. Additional information, if any, which you would
like to mention in support of your suitability for
the post. Enclose a separate sheet, if the space is
insufficient.
18. Remarks … … …
Date: (SIGNATURE)
Mobile No. ……………………….
Certified that the service particulars given by the applicant are verified with reference to service records and found to be correct.
Signature with seal of the Competent Authority