Application Form (Intake) - Special Recruitment Drive For Persons With Disabilities, India

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RAJA RAMANNA CENTRE FOR ADVANCED TECHNOLOGY, INDORE
Special Recruitment Drive for Persons with Disabilities
APPLICATION FORM
For office use only
Application No. :
Affix Passport size
self attested Photograph
Put “X” in the appropriate box
1.
Advertisement No.
:
RRCAT - 1/2016
2.
Post code
:
PWD/____
Name of the Post
:
3.
Full Name (BLOCK LETTERS)
:
(As per SSC Certificate)
4.
Address
Address for correspondence with pin code
Permanent Address with pin code
Phone No.
Mobile No.
E-mail ID
D
D M M Y Y Y Y
5.
Date of Birth
:
6.
Nationality
:
7.
Marital status
:
Married
Unmarried
8.
Religion
:
9.
Whether belongs to Minority Community
[Muslim/Christian/Sikh/any other (Please specify)]
10.
Whether belongs to
:
SC
ST
OBC
GEN
Please specify Sub-caste
:
11.
Were you domiciled in Kashmir Division of the State
Yes
No
of Jammu & Kashmir during the period from
01.01.1980 to 31.12.1989 ? If yes, please attach the
relevant documents
12.
Are you children / family member of those who died
Yes
No
in 1984 riots ? If yes, please attach the relevant
documents.

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