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Recruitment of District Public Service Manager-2017
Fields marked with
*
are mandatory
STATE PUBLIC SERVICE AGENCY
Personal Details
Applicant's First Name
*
Applicant's Middle Name
Applicant's Last Name
Father's/Husband's Name First Name
*
Father's/Husband's Name Middle Name
Father's/Husband's Name Last Name
Mother's First Name
Mother's Middle Name
Mother's Last Name
Category:
*
Nationality:
*
Domicile of MP:
*
Marital Status:
*
Are You an Ex Serviceman
*
No. of Children
Last child birth date
(In DD/MM/YYYY)
Is Your Last Child Born Twins
Gender
*
Date of Birth
(dd/mm/yyyy)
*
(In DD/MM/YYYY)
Age as on 01/01/2017
-
-
(yy-mm-dd)
Are You Physically Handicapped
*
Type Of Physically Handicapped
Type of Identification
*
Identification No.
*
Is Nagar Sainik
*
Educational Qualification
Have you completed your Degree with minimum 60% Marks
*
Qualification
Name of the Degree
Stream
Passing Year
University/Board
Institute/College Name
Obtained Percent (In
00.00
Format)
10th
*
High School
12
th
/Diploma
*
Higher Secondary/Diploma
Diploma
*
Degree
*
Others
* In case your University/Institute does not award marks, please convert grades(CGPA) to Percentage marks and fill.
* Write % of marks with two digits after the decimal. The second digit after the decimal should be rounded off. e.g., if Marks is 60%, then write 60.00%. If marks are 68.938% then write 68.94%.
Work Experience
Do you have working experience in electricity distribution and management.
Company Name
From date
(In DD/MM/YYYY)
To date
(In DD/MM/YYYY)
Total experience
0YY 0 MM 0DD
Experience Details
Government Experience
Whether there is an employee working on contract basis in Government Department / Enterprise / Board / Government Self-Government Organization.
*
Organization Name
From date
(In DD/MM/YYYY)
To date
(In DD/MM/YYYY)
Total experience
YY
0
MM
0
YY
0
MM
0
YY
0
MM
0
Total work Experience in Years-Month :-
0
-
0
Private Experience
Whether there is an employee working on Private Organization.
*
Organization Name
From date
(In DD/MM/YYYY)
To date
(In DD/MM/YYYY)
Total experience
YY
0
MM
0
YY
0
MM
0
YY
0
MM
0
Total work Experience in Years-Month :-
0
-
0
* If yes, NOC from the organization will need to be produced at the time of Joining.
Communication Address
Address
*
State
*
City/Town
*
Pin No.
*
Email id
*
Mobile No.
*
Phone No.
Permanent Address(Same as Communication Address)
Address
*
State
*
City/Town
*
Pin No.
*
Mobile No.
*
Phone No.
Bank Details
Account Number
*
Bank Name
*
Account Holder Name
*
IFSC Code
*
Instructions
Documents to be furnished in original at the time of verification of documents along with one set of photocopies attested by a Gazetted officer and a copy of online submitted application form / Receipt
Certificate of Graduation Degree / Diploma.
Each Semester / Year Mark sheet of Graduation Degree / Diploma.
10th Board exam Mark sheet as proof of date of birth.
12th Board exam Mark sheet.
NOC from present Employer of Govt./Corporation/Board/Autonomous Institutes and Home Guards.
Proof for availing benefit of age relaxation / reservation.
Caste certificate for SC / ST / OBC category candidates. OBC category candidates will also have to produce non creamy layer certificate.
MP Domicile certificate for SC / ST / OBC / UR category candidates.
Copy of address proof of candidate.
Copy of ID proof of candidate.
Attachment
*
Attach Photo with Signature
*
Upload Photo with Signature
Click here for photo sign format