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PROFORMA FOR APPLICATION

TO,

The General Manager,

Cordite Factory,

Aruvankadu,

The Nilgiris-643!

Ta"il Nadu

!# $ost A%%lied For! Na"e in &lock 'etters

(as "entioned in #!thstd) certi*cate+!3 Fathers .us/ands Na"e!4 0ate o1 &irth 0ay(dd

+

Month(""+ 2ear(yyyy+

! Nationality!6 CasteCategory

(Mention hether

5C5TO&C7890O809:O7C;0 8OM;N+!< Address = %in code in 1ull 1or co""unication

!> Nearest 7ailay 5tation!? $hone Mo/ile Nu"/er

#! ;-"ail 90## To $ro"inent and visi/le identi*cation Marks 9+

99+# 'anguage in hich @uestion %a%er is re@uired

%lease tickOther than the %ost o1 Multi Tasking 5ta

;NG'95.

.9N09

#3 'ANGAG; 9N 8.9C. $A$;7 95 7;B79;0

$lease tick Only 1or the %ost o1 Multi

Tasking 5ta

;NG'9

5.

.9N09 TAM9'

#4) 0etails o1 educational and other @uali*cations starting 1ro" 5tandard 55'CD

Na"e o1 5choolCollege Na"e o1 7ecogniEed

niversity&oard o1 ;a"ination

;a"ination

$assed

2ear o1

%assing

#) Only 1or the %ost o1 'O8;7 09:959ON C';7

Tying s%eed on Co"%uter (Mandatory+H9 5elect

oneI

3 ords) %er "inute in;NG'95.

3! ords %er "inute

in .9N09

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HTy%ing on co"%uter ith the s%eci*ed s%eed is co"%ulsory,

Mediu" o1 5tenogra%hy Test (5elect One+ ;NG'95. .9N09#)Only for the post of STENOGRAPHER#6)Whet her Ex-service man if yes. Please frnish the !etail an! enclose self atteste! copy of !ischar"e certificate.

#ate of Entry inArme! $orces

#ate of#ischar"

e

Nm%er of yearsService ren!ere!

Whether service ren!ere! in &entral / State Govt'(asiGovt'Serni Govt. %o!y'Atonomos %o!y after !ate of !ischar"e. if yes frnish the !etails.

#

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< For" o1 nder taking JA%%endi-99 (in case o1 ;- 5ervice"an> $. Certi*cate is %rescri/ed $ro1or"a 1or e"%loy"ent in Central Govt)? NC:T (NTC or NAC+ Certi*cate - i1 a%%lica/le#! 8hether all a/ove docu"ents Certi*cates are sel1 attested## To co%ies o1 5el1 Attested $hotogra%h

DECLARATION

,1 Shri / Smt ' Kum__________________________have rea! the instrctions carefully%efore sen!in" this

application. , here%y !eclare that all the statements ma!e in this application are correct to the %est of my knowledgeand%elief. Iunderstand that any discrepancy fon! in the information ill lea! to cancellation of my candidature '!e%arment at any time.

Left han! thm% impression of the can!i!ate Si"natre of the &an!i!ate#ate2

Place2