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Tick The Relevant Box

The document is an application form for the post of Assistant Engineer (Mechanical/Civil/Electrical) in the Greater Chennai Corporation. The application requests basic personal details such as name, address, date of birth, gender, marital status, educational qualifications, category and other details. It lists the required enclosures including educational certificates, caste certificate, and passport size photo. It also includes a declaration by the candidate confirming that all information provided is true.

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88 views4 pages

Tick The Relevant Box

The document is an application form for the post of Assistant Engineer (Mechanical/Civil/Electrical) in the Greater Chennai Corporation. The application requests basic personal details such as name, address, date of birth, gender, marital status, educational qualifications, category and other details. It lists the required enclosures including educational certificates, caste certificate, and passport size photo. It also includes a declaration by the candidate confirming that all information provided is true.

Uploaded by

temp
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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GREATER CHENNAI CORPORATION, RIPON BUILDING, CHENNAI - 600 003.

APPLICATION FOR THE POST OF ASSISTANT ENGINEER


(MECHANICAL) / (CIVIL) / (ELECTRICAL)

APPLICATION FOR THE POST OF

Affixed Photo
1.Name in full (Block Letters) [ should be
attested by the
gazetted officer]
2.Fathers / Husbands Name

3.Gender Male Female Third Gender


(Tick the relevant box)

4.Maritual Status Married Unmarried


(Tick the relevant box)

5.Full Postal Address with Mobile No. & email-id

a) Permanent Address:

--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

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Pincode:

District: Mobile No: email-id:

b) Address for correspondence

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Pincode:

District: Mobile No: email-id:

6.Nationality : Religion :

7. a) Date of Birth : b) Age :


D D/ M M/ Y Y Y Y

(Self attested copy of High School Certificate showing


Date of Birth must be enclosed)

8.a) Mother tongue :


(Please mentioned if Tamil is not mother tongue)

b) Second Language in School :


9.Category [SC(A)/SC/ST/MBC/BC/BC(M)/OC] :
(Self attested copy of Caste Certificate to be enclosed)

10.EDUCATIONAL QUALIFICATION
(Self attested copy of all Educational Qualifications to be enclosed)

Sl.No. Qualification Register No. Year of Marks, Grade Nam of the Institution
Passing obtained with class
Grade % Class
1. SSLC / MATRIC

2. HSC

11.PROFESSIONAL / TECHNICAL QUALIFICATION


(Self attested copy of Certificates as Proof)

Sl.No. Qualification Register No. Year of Marks, Grade Name of the Institution
Passing obtained with class

Grade % Class
1.

2.

12.If candidate belonging to Differently abled persons : (YES / NO)

Type of PH Percentage of PH Certificate No. Name of Issuing


and Date Medical Authority

13.OTHER DETAILS, IF ANY

Note : Stage of the case at the time of applying, Nature of the criminal charge, if acquitted on the date of this
application date of judgement should be given. (Tick the relevant box)

Section of Law

Pending Stage of Case YES NO

Acquitted YES NO

Date of Acquitted
D D M M Y Y Y Y
PARTICIPATION IN POLITICAL

In agitation YES NO

As member of Political YES NO


Organisation

Candidate in Election YES NO

Enclosures (Tick the relevant Column) to be attached

Sl.No. Documents Yes No Not applicable

1. Passport size photos (Colour) 1

2. Date of Birth (SSLC / Matric passed Certificates)

3. Educational Qualifications 10th


(Certificates & Marksheets)

HSC

Degree

4. Community Certificate
[SC(A)/SC/ST/MBC/BC/BC(M)/OC]
in prescribed proforma

5. No Objection Certificate (in case of Departmental


candidates)

6. Differently abled persons Certificate in prescribed


proforma for Employment in State Government

7. Discharge Certificate (in case of Ex-servicemen)

8. Whether all above documents / certificates are


self attested

Signature of the Candidate


DECLARATION

I hereby declare that all the statements made in this application are true and correct to the best of my
knowledge and belief. In the event of any information being found false / incorrect or ineligibility
deducted before or after the written test / certificate verification or even after appointment, my
candidature / appointment will stand automatically cancelled.

Signature of the Candidate

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