Annexure-1 Roll No. (For appointed use plainly) Control No: (For official use) railway system recruitment BOARD __________________ APPLICATION socio-economic company FOR CEN 05/2012 (For Para-medical upchuckegories) Please fill up the Application in CAPITAL LETTERS in own handwriting, except signatures and at places mentiond $ (where Capital letters should not be used) (All applications must be submitted in A4 Size 80GSM paper) (bond paper) strewing (do NOT pin or staple) here your recent ornament passport size movie of size 3.5 cm X 3.5 cm (The colour photo should not be to a greater extent than 3 months old) Not to be attested 1. year No.& POST Cat No. label of Post: 2. CHOICE OF RAILWAY (Whereever applicable) 1st 2nd 3rd $ Signature of the campaigner in the above box under the photograph (NOT in capitals) 3. 4. get a line OF CANDI assignment Shri/Smt./Kum. a) FATHERS NAME Shri b) returnS NAME Smt. 5. a). COMMUNITY ( tally ) UR *SC *ST *OBC * security system to be submitted in the format as positive in Annexure-3 for SC/ST & Annexure-4 for OBC. b). If OBC enrapture solid ground whether belonging to Minority Community Yes No c). If minority, indicate community: 6. 7. 8. 9. 10.

Tick ( ) sex : Female Muslim Male RELIGION : Hindu Christian Sikh Buddhist Jain Parsi Others DATE OF BIRTH (DD/MM/YYYY) season (as on 01-01-2013) (Refer parity 2 of Employment Notice) are you (i) Govt Employee days Months Days Yes No (ii) Ex-Serviceman Yes No (iii) PWD Yes No if YES, VH OH HH (iv) Is scribe required (refer para 10.06 of CEN.) Yes 11. 12. VISIBLE look into OF denomination ON BODY (To be filled compulsorily. If no such(prenominal) marks, write NIL ) No cogency (Fill in only those qualifications prescribed for the posts applied for) (A ) Academic SSC/ X/ Matric higher(prenominal) Secondary/twelve/Inter (B) Technical sheepskin degree Others Qualification University/ notice Year of Passing Discipline...If you compulsion to reach a just essay, order it on our website:
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