Application Form (Intake) - Special Recruitment Drive For Persons With Disabilities, India Page 2
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13.
Are you a Central Govt. Civilian employee ?
Yes
No
If yes, please attach necessary certificates
14.
Indicate the type of Disability
(i)
Nature of disability, indicate the category
VH
HH
as VH/HH
(ii)
Mention the percentage of disability (as
certified by the Competent Medical
Authority in the PH Certificate)
th
15.
Educational & professional qualifications (Beginning with 10
Std. ) :
Examination
Board / University
Year of
Subjects
Details of Marks
passing
Max.
Marks
% of
Marks
obtained
Marks
16.
Course of study, the applicant is continuing presently :-
Course of study
Board / University
Full time /
Duration of the
No. of semester/
Marks
Part time
course
subjects completed
obtained
17.
Experience, if any (particulars of all previous and present employment are to be furnished)
Name & address of
Post held
Whether Central or
Period
Permanent
Reasons
employer
a State Govt./PSUs/
or
for leaving
From
To
Autonomous bodies
Temporary
Total experience
Year
Month
18. Details of relatives employed in DAE or its constituent units :-
S.N.
Name
Relationship
Unit
Post held
19.
Are you in receipt of any scholarship from the Department of Atomic Energy? If so, please furnish
particulars.
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