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Name [Last]  [First]  [Middle]  Date of birth ________ [Day]  ___________ [Month]  __________ Year]  Fathers Name/Husbands Name [in case of married women] : Correspondence Address {Please fill up Block Capital Letters} Telephone No. with STD Code [Residence]Telephone No. with STD Code [Office]MobileE-Mail   Permanent Address {Please fill up Block Capital Letter} SexMarital StatusNationalityReligionHome Town and StateWhether SC / ST / OBC / PH [kindly mentioned OH / HH / VH and attach attested copy of certificate] / Ex-Serviceman / General, please specify If SC / ST / OBC, please specify Sub Caste and attach attested copy of certificate issued by the appropriate authority Language Known LanguageReadWriteSpeak  -2- Continuation Sheet 2. Educational / Professional Qualification [Starting from School Final [ Class X ] onwards] {Please fill up Block Capital Letters} [ If space is insufficient, please attach separate sheet] ExaminationUniversity / Board / Institute [Location]From To Divn. / GradePercentageSpecializationSpecial achievement       Work Experience [Starting from present organization] {Please fill up Block Capital Letters} [ If space is insufficient, please attach separate sheet] Name & address of Company and nature of businessPosition heldYear of service From | To [MM/YY] MM/YY]Total experience in years & monthsGross Annual SalaryMajor responsibilities              Details of present Salary and Benefits & Scale of Pay/Pay Band & Grade Pay (for Government Employees) [ If space is insufficient, please attach separate sheet]  Expected Salary :  -3- Continuation Sheet 3. Membership of Professional Organization Name and Address of OrganizationsType of membership  Extra curricular activities / Hobbies / Sports, etc.  Any other information, please specify  FAMILY DETAILS Dependants NameSexDate of birthRelation With applicantOccupation   -4- Continuation Sheet 4. REFERENCES [Please give name, address and telephone numbers [office and residence] of two persons under whom you have worked or have had professional interaction ] Sl.No.NameAddressTelephone No. and Email-id   NOTE : Furnishing of false information in the case of a candidate selected and employed will be treated as a misconduct DECLARATION I certify that the foregoing information is correct and complete to the best of my knowledge and belief. 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