APPLICATION FOR THE POST OF __________________________
one recent passport
size photograph to
be affixed here
Name of the Candidate (in capital letters)
1.
2. Gender
3. (a) Date of Birth (Proof to be attached)
(b) Age as on 01.06.2019
4. Marital Status
5. Name of parent / guardian / Husband
6. Nationality
7. Religion
8. Community (Proof to be attached)
9. Educational Qualification with passing Year of % Course
month, year and class (starting from Passing
immediate recent to backwards ) .
10th
12th
UG
PG
Other
Experience : No.of
Details
(Certificate copy to be attached) Years
(i) Government
10.
(ii) Private
..2..
11 Permanent Address (Valid residency Proof)
12 Address for communication
13. Contact Numbers
14. E Mail_ID
15. Signature of the Candidate
NOTE : Filled in application with relevant enclosures / documents duly self attested to be sent
only through registered post / Speed post so as to reach on or before upto
5.45 pm to the following address. Applications received after the above date will be summarily
rejected. Original certificate should not be sent along with the application. The envelope may
be superscribed with “Application for the post of ____________________ @
______________________ District / _______________________ Block.
Director cum Mission Director,
Integrated Child Development Project Schemes,
No.6, Pammal Nalla thambi Street, M.G.R. Road,
Taramani, Chennai - 113.