SJVN Limited: / SSC Certificate)
SJVN Limited: / SSC Certificate)
SJVN Limited: / SSC Certificate)
Affix recent
APPLICATION FORMAT
(Use Block Letters Only)
passport size
Photograph
here
th
2. Fathers
Name
3. Date of Birth
DD
4.
5.
State of Domicile:
6.
Name of Tehsil :
MM
YYYY
Yr
Month
Days
Sex: (Write M or F)
Himachal Pradesh
B. CORRESPONDENCE ADDRESS:
City/Town:
State
STD Code
Pin Code:
Telephone Number
C. PERMANENT ADDRESS:
City/Town:
State
STD Code
Pin Code:
Telephone Number
Tehsil
Mobile No.
D. ACADEMIC PERFORMANCE :
1.
Exam
Passed
Duration of
study
Aggregate%
of marks *
Full Time /
Part Time/
Correspondence
2.
Institution/
University/
Board
Duration
of study
Month &
Year of
passing
(MM/YYYY)
Aggregate%
of marks *
Full Time /
Part Time/
Correspondence
E. Category:
GEN/SC/ST/OBC/Ex-ser
Type of handicap:
G. Have you ever been convicted by any court of law or any disciplinary proceedings/enquiry is pending
against you or any penalty has been imposed upon you? If yes, give details.
Declaration:
I affirm that the information given in this application is true and correct to the best of my
knowledge and belief. I further undertake that if at any stage it is discovered that an attempt has
been made by me, will fully to conceal or misrepresent the facts, my candidature/appointment
shall be summarily rejected or terminated without any notice.
Date: _______________________
Signature:________________________
Place: ______________________
Name: _______________________
Please Enclose:
1.
2.
3.