Application Form West Bengal Police Website Page 2
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26. *Educational Qualification (From X Standard / Madhyamik onwards)
Name of Examination / Class passed
Year of Passing
Name of Board / University
Madhyamik / Equivalent
Higher Secondary
Graduation
Post Graduation
Y
Y
Y
Y
M
M
D
D
7. Date of Birth :
Y
Y
M
M
D
D
8. Age as on 01.01.2015 :
9. Do you belong to SC/ST/
S T
S C
OBC -
OBC - B
A
OBC-A/OBC-B?
If, yes, tick (√) the respective box.:
10. *Payment Details
:
IPO / Demand Draft No. (SBI)
:
Issuing Post Office / Bank Branch :
(SBI)
SBI Branch Code
:
11. Are you Ex-Navy, Indian Coast Guard, :
Navy
Indian Coast Guard
BSF
ITBP
BSF Water Wing, ITBP Water Wing
personnel?
12. Put a tick (‘√’) on, if you have enclosed : i) Certificate in support of proof of date of birth
ii) Discharge Certificate issued by previous employer
iii) Caste Certificate
13. Mobile No
:
14. Declaration :
I solemnly declare that all statements made in this application form are true, complete and correct
to the best of my knowledge and belief. In the event of any information being found false or incorrect, or if my
ineligibility is detected before, during or after the test and medical examination, my candidature will stand
cancelled and my claim to recruitment will stand forteited. I also declare that I have submitted no other application
form for this examination.
Place : __________________________
Yours faithfully,
Date : __________________________
____________________________
(Full signature of the candidate)
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