GOVERNMENT OF INDIA
भारत सरकार
MINISTRY OF LABOUR AND EMPLOYMENT
श्रम और रोजगार मंत्रालय
DIRECTORATE GENERAL OF EMPLOYMENT
रोजगार महानिदे शालय
NATIONAL CAREER SERVICE CENTRE FOR SC/ST
अिुसूनित जानत/अिुसूनित जिजानत के नलए राष्ट्रीय कैररयर सेवा केंद्र
VRC (H) BUILDING, EN-81, SALT LAKE, KOLKATA-700091
Email ID: cgc.kolkata@gmail.com Ph. No. 033-23572008
(All in Block Letters only)
Give Serial wise Course preference:-
1. STENOGRAPHY 2. ‘0’LEVELCOMPUTERSOFTWARE 3.COMPUTERHARDWAREAND
MAINTENANCE
4. OFFICE AUTOMATION 5. COMPUTERAPPLICATIONAND 6. CYBERSECURED WEB
ACCOUNTING & PUBLISHING BUSINESS ACCOUNTING ASSOCIATE DEVELOPMENTASSOCIATE
ASSISTNAT
1. Name of the Applicant : _______________________________________________________________
2. Father’s Name & Occupation : ___________________________________________________________________
3. Date of Birth & Age :____________________________________________________________________
PHOTO
4. Category : Scheduled Caste Scheduled Tribe
5. Family lncome per annum : Below3 lakh or Above3lakh
6. PermanentAddress : ____________________________________________________________________________________________
______________________________________________________________ Pin Code:- _________________
7. Email Id :_____________________________________________________________________________________________________
8. Mobile No. :_______________________________________________________________________________________________
9. National Career Service Portal Registration Number :-
10. Name of Competative Examination for which Preparing (e.g. SSC, Banking etc.):-
11. Educational Qualification:-
SL Name of Board / Yearof Subjects Percent Division/
Examination University Passing age Grade
No.
1. Matric
2. Senior Secondary
3. Graduation
4. Post-Graduation
5. Others
12. Whether applicant possesses the minimum educational qualification required for the competitive examination for which appearing ?
YES NO
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13. StateEmployment
Exchange/Employment Bank : ______________________________________________________________________________________________________________
Portal Registration ID
(Mandatory)
14.Bank and Aadhar details for stipend (Mandatory)
a. NameoftheBankAccountHolder :
b. BankAccountNumber :
c. NameofBank :
d. Bank IFSCCode :
e. BankbranchName :
f. AadharNumber :
g. WhetherBankAccountlinked : Yes/no(Ifnolinkaadharwithbankaccountwithin15daysandinform
withAadhar thiscentrg)
h. WhetherMobilenumberlinked : Yes/no(Ifnolinkaadharwithmobilenumber within15daysandinform
withAadhar thiscentre)
15 . Whether the applicant has enrolled in any course run by NCSC for SC/ST (CGC FOR SC/ST), Kolkata earlier? :- yes No
If Yes, Please provide details:
a) Name of NCSC for SC/ST Centre :-
b) Name of course under which enrolled:-
c) Year of Enrolment
d) Course Completed: yes No
e) If dropout, specify reason :-
DECLERATION
son/daughter of
Hereby declare that I belong to the sub-caste which is recognized as a Scheduled
cast/scheduled tribe by the government of India and the particulars furnished above are true and correct to the best of my knowledge and
belief.
Date Place: Signature of the Applicant
Enclosure:-
Self –Attested Photocopies of following Documents (Please tick the documents enclosed)
1. Certificates in support of Educational Qualification 2. Aadhaar Card 3. Bank Passbook 4. Caste Certificate
5. Four Passport Size Photograph 6. Employment Exchange/NCS Portal Registration Number 7. Income Certificate
FOR OFFICE USE ONLY
Advice Given: Selection test will be held on at am subjects for test are General awareness and General
English. Candidate has to carry this slip for selection test.
Application No. ___________________________________________
Date.
