Application Form

RECRUITMENT FOR OFFICE ASSISTANT CUM DEO,NARSINGHPUR-2022

Fields marked with * are mandatory

Instructions
Documents to be furnished in original at the time of verification of documents along with one set of photocopies attested by self and a copy of online submitted application form / Receipt

Personal Details
Applying for Post *
Applicant's Name in Hindi*
Applicant's Name in English*
Father's/Husband's Name*
Mother's Name*
Category:*	Nationality:*
Gender*	Date of Birth(DD/MM/YYYY)*	Age as on 01/01/2022	- -(yy-mm-dd)
Are you Physically Handicapped?*	Are you Domicile of MP? *			Employment Registration No. *
Are You an Ex Serviceman*

Marital Status
Marital Status:*		Date of Marriage(DD/MM/YYYY)		No. of Children
Last Child Birth Date (DD/MM/YYYY)		Is Your Last Child Born Twins?

Educational Qualification

Qualification	Name of the Degree	Stream	Passing Year(YYYY)	University/Board	Institute/College Name	Total Marks	Obtained Marks	Obtained Percent
Details of Diploma in Civil Engineering *
10^th*	10th
12^th*	Higher Secondary
Diploma in Computer from recognized University/Institute by U.G.C.*

* 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%.

Typing Qualification Details
Name Of Certification *		Passing Year *		Name Of Institute *

CPCT Exam Information*
CPCT Exam Date (DD/MM/YYYY)	CPCT Total Marks	CPCT Obtained Marks	English Typing (WPM)		Hindi Typing (WPM)

	Result	QualifyDisqualify	Result	QualifyDisqualify	Result	QualifyDisqualify

Work Experience
Are You Serving in State Government/Corporation/Board on the Contract Term? (If so, the applicant appointment order is compulsory to attach)
Do you have Knowledge of English and Hindi Typing?*
Do you have Knowledge of Data Feeding?*
Do you have 3 Years Experience in Ms Office and Database Software?* (Experience Letter is compulsory to attach)

Communication Address
Address*
State*	District*	PinCode.*
Email id*	Mobile No.*	Phone No.

Permanent Address(Same as Communication Address)
Address*
State*	District*	PinCode*
Mobile No.*	Phone No.

Bank Details
Account Number		Bank Name
Account Holder Name		IFSC Code

Read form carefully before submission.*

I, hereby declare that the above details are true, correct and complete in all respects to the best of my knowledge and belief and nothing has been concealed and in the event of any information being found false/fabricated or any deficiency in the eligibility of the post being detected at a later stage, my candidature is liable to be summarily cancelled/rejected.