Job Application Form | CSIR-CSMCRI Bhavnagar

Basic

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Name of the Post applied for

Post Code

Subject

Candidate Information

Name of the Candidate

Father’s/Husband’s name

Mobile No

Email Id

Telephone

Date of Birth

Age as on last date of application

Years

Month

Days

Place of Birth

Have you registered your name in the National Register compiled by CSIR?

Yes

Address for correspondence (IN BLOCK LETTERS)

Are you an Indian citizen by birth or by domicile?

By Birth

By Domicile

Is/Was your father an Indian citizen by birth or by domicile?

By Birth

By Domicile

Are you an immigrant from Pakistan intending to settle in India permanently?

Yes

Is/Was your father an immigrant from Pakistan intending to settle in India permanently?

Yes

Are you a subject of Nepal or Sikkim?

Yes

Is your father a subject of Nepal or Sikkim?

Yes

Sex

Male

Female

Marital Status

Married

Unmarried

Other…

Languages known

HINDI

ENGLISH

Religion

State whether you are a member of Scheduled Caste/Scheduled Tribe/Other Backward Class/PH. If so, attach an attested copy of the certificate

Fee Exempted

Persons with Disability

Yes

Name of the state to which you belong

Are you an Anglo-Indian

Yes

Details of the Higher Studies

Examination Passed

Year of passing

Division/Grade and % age of marks

Board/University

Subject's

Do you know typing?

YES

Do you know shorthand?

YES

Educational qualifications commencing with Matriculation/SSC or equivalent examination

Examination Passed

Year of passing

Division/Grade and % age of marks

Board/University

Subject's

Do you have the knowledge of Computer?

Yes

Employment Details

Whether you are presently a Government Servant? If yes, please state whether you are permanent or temporary.

Post Held

Scale of pay & last pay drawn in RS.

Organization

Start date

End date

Total period (in years, months & days)

Nature of Duties

Have you ever been to abroad?

Yes

Are you willing to accept the minimum initial pay offered? If not, state what is the lowest initial pay you wold accept in the prescribed scale.

Yes

State here

If selected, what minimum days notice period you would require before joining?

Particulars of the post under CSIR, if any, for which you were an applicant:

YES

Details of post-graduate work and published papers. Give titles of papers here and attach reprints.

Add Two References

[They should be residents in India and holders of responsible positions. They should be intimately acquainted with the applicant’s character and work but must not be relations. When the candidate has been in Employment, he should either give his present or most recent employer or immediate superior as a referee or produce a testimonial from him in regard to the candidate’s fitness for the post for which he/she is an applicant.]

Name	Occupation or Position	Address	Operations
Name	Occupation or Position	Address
Name	Occupation or Position	Address

List of Testimonials (Maximum three)

Maximum 3 files.
19.53 GB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
3 MB limit per form.

List of Enclosures

Unlimited number of files can be uploaded to this field.
19.53 GB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
3 MB limit per form.

Payment

D.D. No. & Date

Issuing Bank

Declaration

I declare that the information and details furnished in this application form are true and correct to the best of my knowledge and belief, and I will not willfully suppressed any material fact.

Math question 5 + 10 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.