MAKHANLAL CHATURVEDI RASHTRIYA PATRAKARITA EVAM SANCHAR VISHWAVIDYALAYA 38-B, Vikas Bhawan, Press Complex, M.P.

Nagar, Zone-I, Bhopal-462011

APPLICATION FORM
(For Non-Teaching Posts)

Application for Employment in response to Advertisement No. 01/Admn./2012 (Last date of receipt of application form is 30.04.2012) D.D. for Rs. :_______________________________ D.D. No. & Date: __________________________ Bank Name & Branch : ______________________ __________________________________________ 1. 2. 3. 4. Name of the Post Name of the Applicant (In Block letters) Fathers Name Date of Birth Age (As on 30-04-2012) 5. Present Address for correspondence ......... ......... ......... ............. Years Months Days
Passport Size

Photo

......... ......... .........

Telephone/Mobile No. 6. Permanent Address

......... ......... .........

7.

......... Academic qualifications beginning with High School/Senior Secondary Exam. (Please attach one set of attested copies of certificates & degrees detailed below)
Subjects Year Percentage of Marks/ Grade Point Board/University

Examination passed
HIGH SCHOOL (10th) SENIOR SECONDARY (10+2) GRADUATION POST GRADUATION OTHER QUALIFICATIONS, IF ANY

(1)

8.

Experience (Attested copies of testimonials must be attached): Post Held Employer Last pay drawn & pay scale From----To Total duration

S.No. 1. 2. 3. 4. 5. 9.

Whether SC or ST or OBC or disabled (If yes, a copy of certificate from competent authority should be attached) - Yes/No SC ST OBC disabled

10.

Any-thing else worth mentioning not covered above.

11.

Details of Enclosures : I. II. III. IV. V.

Place-----------------------------Date-----------------------------Note1. 2. 3. 4. 5. 6. Incomplete applications and the applications received after due date will not be entertained. Please attach self addressed envelop (11 c.m. x 23 c.m.) along with the application form. TA/DA will be paid only to SC and ST candidates for attending the written test and/or interview. University reserves the right either to fill up the post or not to fill up the post. Candidates already employed should furnish NOC from the present employer. The jurisdiction, in case of any cause of action, shall be limited to the Bhopal district Court only. (2) Signature of the Applicant