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STANDARD FORM OF APPLICATION
(As prescribed in the Part-IX of the Gazette of Meghalaya)
To
Passport Size
Photo
Dated: ________
___________________________________
___________________________________
___________________________________
Sir/Madam,
I beg to apply for the post of _________________________________________ and furnish
the facts/as below in case of any false statement I am liable to any action Government may deem fit and
proper. A Treasury Chalan of Rs. ____________ Vide T.V. No.___________ is attached herewith.
Signature of Applicant
1. Full name in capital letters with address; if any; Surname first
(Please do not use any initials):
________________________
Surname
__________________
Middle Name
________________________
First Name
2. Date of Birth:
____________
Year
____________
Month
____________
Date
3. Place of Birth:
_______________
Village/Town
_______________
Police Station
_______________ _______________
District
State
4. Father’s/Mother’s and Husband’s name (in case of married female)
(Please do not use initials):
_________________________________
5. Personal Description:
A. Height: ____ M ____ Cm
C. Colour of Hair:
________________________
6. A. Permanent Address in full:
B. Colour of Eyes: ___________
D. Visible distinguishing marks (if any):
__________________________________
B. Present Address in full:
_____________________________________
____________________________________
_____________________________________
____________________________________
_____________________________________
____________________________________
C. If you have not resided at the above address continuously for the last four years. Please give the
other address where you have resided during the period.
From: ____________ To: ____________
Address:
____________________________________
____________________________________
____________________________________
____________________________________
7. References:Name and address of two responsible persons in your localities who would be prepared to vouch for
you.
A. ____________________________________
B. __________________________________
____________________________________
__________________________________
____________________________________
__________________________________
____________________________________
__________________________________
8. Are you citizen of India? If so, how? (Copy of Citizenship Certificates should be enclosed where
necessary):
Yes, Indian by birth
9. Educational and other qualifications (Please attach copies of Certificates, Mark Sheets etc.)
Sl.
No.
Name of Institution and
Address
2
Board/
University
3
Examination
Passed
4
Subject
Taken
5
Year of
Passing
6
Divisio
n/Grade
7
Percentag
e
8
1
2
3
4
5
10. Community: ____________________
a) State your religion:
______________________________
(b) Are you a member of Scheduled Caste/Scheduled
Tribe? Answer “Yes” or “No”. If “Yes” give particulars
supported by a Certificate (Copy to be enclosed).
_______________________________________
11. Present Occupation, if any:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________ _______________
12. Previous appointment held, if any:_____________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
13. Are you a temporary/retrenched personnel of temporary Department of the Government of Meghalaya, Answer
“Yes” or “No” (If “Yes” give particulars):________________________________________________________
_________________________________________________________________________________________
14. Are you married or unmarried?: ______________________
Signature
Note: Particulars are to be filled in below the column in the space provided.
Sandard Form Blank - PDF 2017.pdf (PDF, 17.44 KB)
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