PROFORMA FOR APPLICATION
APPLICATION FOR THE POST OF – LDC in HQ WAC (U) AF, SUBROTO PARK Unit
(1) Post applied for: LOWER DIVISION CLERK Paste a Self
attested
(2) Name of Candidate: DEVANSH RAJ Photograph
(3) Father’s Name : RAM UDAY KUMAR
(4) Date of Birth : ………21..…../……05….……/………2003.……
(attach copy of Birth Certificate self attested)
(5) Age as on the last date : Years 21 Months 02 Days 25 (prescribed for receipt of application)
(6) Address for correspondence
House No/Street/Village – H NO. 47/1 GALI NO.5 RAJNAGAR PART 1 PALAM
Post Office - PALAM Dist – SOUTH WEST State- DELHI Pin Code – 110077
( 7) Permanent House
House No/Street/Village VILL NONI
Post Office - NONI Dist - Jamui
State.- BIHAR Pin Code – 811301
(8) Caste Gen/OBC/SC/ST :- GEN
(attach self attested certificate in case of SC/ST/OBC)
(9) Educational Qualification : 12th
(attach education certificate self attested)
(10) Any other qualification/Experience: ……………………………….…….………..
(11) Category for which applied : Gen(UR)/OBC/SC/ST/EWS/Ex-
Serviceman/Meritorious Sport person/ Physically Handicapped - EWS (attach self attested
copy)
(12) Technical Training/Experience: CCC Certificate
(13) Domicile : BIHAR (attach self attested copy)
(14) Whether registered with any Employment Exchange: Yes/No - NO
(If yes, mention Registration No and Name of employment exchange)
(15) I hereby certify that above particulars mentioned in the application are correctand true to
the best of my knowledge and belief, if particulars mentioned by me are found false at any stage
then I shall be liable to be terminated without any notice.
Date : Signature of candidate
FOR OFFICIAL RECORD ONLY
1. Received on …………………………….
2. Accepted/Rejected …………………….
3. Reason for rejection: Underage/Overage/incomplete/Any other reason to be specified
…………………………………………………………..
4. Index No: ………………………..Date of Test / skill / practical / physical test.
Acknowledgement Card
Paste a
Post of LOWER DIVISION CLERK
Self
attested
(1) Name : DEVANSH RAJ Photograp
h
(2) Father’s Name : RAM UDAY KUMAR
(3) Address for correspondence (To be filled same as per Column 6 of application form)
House No/Street/Village- H NO. 47/1 GALI NO.5 RAJNAGAR PART 1 PALAM
Post Office- PALAM Dist- SOUTH WEST
State – DELHI Pin Code - 110077
(4) Index No: …………………………. Date and Time of Test / skill / practical / physical test
…………………………………..
(5) Venue of Written Test / skill / practical / physical test ……………………………….
Signature of Controlling Officer