Professional Documents
Culture Documents
1. Personal Details
: ____________________________
: ____________________________
: _________________________
: _________________________
(Attach copy of Class Xth Certificate / School leaving Certificate with hard copy of Application
Form)
Category
* (Gen. / SC / ST / OBC)
_____________________________
(Attach copy of Caste Certificate in case belongs to reserved category with hard copy of Application
Form)
* Whether belong to
: _________________________
: _____________________________
Whether applicant is
Ex-Serviceman (Yes / No)
: _________________________
: _____________________________
: __________________________
(Single / Married)
Mobile No.
Complete Permanent
* Residential Address
_____________________________
: _____________________________
: __________________________
Complete Current
* Residential Address
: __________________________
_____________________________
__________________________
____________________________
__________________________
_____________________________
__________________________
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Year of
Passing
Percentage
obtained
10th
12th
Graduation
(B.A., B.Com, B.Sc etc.)
Use extra sheets, if required. Attach copies of all mark sheets, certificates duly self-attested with hard copy of Printed Application Form.
College Name
Duration
of the
Course in
Years
Year of
Passing
Whether
Regular/
Part Time /
Distance
Specialization /
Discipline
Percentage
/ Grade
obtained
Use extra sheets, if required. Attach copies of all mark sheets, certificates duly self-attested with hard copy of Printed Application Form.
Duration
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Name of Employer
Position
held
Executive
or NonExecutive
Gross Salary
per month
(in Rs.)
Use extra sheets, if required. Attach copies of all experience certificates duly self-attested with hard copy of Printed Application Form.
6. If presently working with Government / Semi-Government / PSUs/Banks / Local Bodies etc., please give Name & Address of HR
Head / Personnel Department.
Name & Address of the HR Head / Personnel Deptt. : ________________________________________________________
_________________________________________________________
7. * Have you ever appeared in interview for any post in NSIC during last 3 years? :
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________________________________
________________________________
________________________________
Telephone
________________________________
: ________________________________
________________________________
Telephone
: ________________________________
* Date: ______________
Self-Declaration of applicant:
Yes
(a)
I have verified the above details, and the details are in order to the best of my knowledge & belief.
(b)
I understand that merely filling this Application Form will not be treated a complete application. Therefore, I further declare that I will send this
Application Form with self-attested photo pasted at appropriate place, copies of all self-attested credentials of caste, disability, work experiences,
qualification to DGM(HR), NSIC Ltd. so that the same is received on or before 28.07.2015.
* Signature of Applicant
Fields marked * are mandatory, in case full information is not filled, the Application Form will be rejected.
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