Application Form For EA CSIR NPL
Application Form For EA CSIR NPL
A. Personal Information
Name in full
(in block letters):
Father’s Name:
Affix Recent
Nationality: Photograph
Religion:
Gender: Male Female
Category: Gen SC ST OBC PH
Date of Birth Date Month Year
(as per SSLC/ HSC/
SSC/ Matric Certificate)
Address for
Communication:
City: Pin code:
State:
Phone with STD
code/ Mobile No.:
E-mail:
List Name & Address of Position Held and Period Permanent/ Salary & Grade
the employer Nature of Work From To Temporary (annual)
List two references (not relatives) having knowledge of your work performance, who might be
contacted, if needed.
DECLARATION
I ______________________________ hereby declare that all the statements made in this application are
true and complete to the best of my knowledge and belief and nothing has been concealed/ distorted. I
am aware that, if at any time I am found to have concealed/ distorted any material/ information, my
engagement as Executive Assistant is liable to be summarily terminated without notice.
Date
Place:
:
Signature