Manager Pist

7/24/2019 Manager Pist

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PARADIP PORT TRUST

ADMINISTRATIVE DEPARTMENT

APPLICATION FOR ENGAGEMENT OF :.

1. Name of the Candidate (in Block

letters)

:_________________________________

2. Fathers/Husands Name : ____________________________________

!. "ate of Birth (dd/mm/####) : ________________________________

$. %&e as on '1.'1.2'1 :______________________________________

. *ermanent %ddress (+ith ,in code) : __________________________________

. %ddress for corres,ondence (+ith ,in

code)

: __________________________________

-. mail address0 ,hone numers (office0

residence moile) alon& +ith fa no.

if an#

mail:__________________

3o: ___________________

*h (off): ________________

*h (4es): ________________

5. 4eli&ion :

6. 7hether elon& to

3inorit#/Communit#0 if #es0 ,lease

s,ecif#.

:

1' 7hether elon&in& to 8C/89/BC :

11 ;ender :

12. "etails of ducational nstitute

d) ?ni@ersit#/ Board


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e) 3ain suAects

f) 9otal a&&re&ate

,ercenta&e of marks

otained0 di@ision and

remarks0 if an#


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1!. "etails of e,erience (in chronolo&ical

order). (nclose a se,arate sheet0 dul#

si&ned0 if the s,ace elo+ is

insufficient. : ________________________________

8l. No. (1) (2) (!) ($) ()

a. Name of or&aniation

. *ost held +ith dates From

9o

c. Brief descri,tion of

duties

d. "etails of e,erience

e. 8alar#

1$. "etails of com,uter kno+led&ean&ua&e(s) kno+n and a,,lication

8oft+are used :_________________________________

1. %dditional information0 if an#0 +hich #ou

+ould like to mention in su,,ort of #our

suitailit# for the ,ost (9his amon& other

thin&s ma# ,ro@ide information +ith

re&ard to (i) additional academic

Dualifications0 (ii) ,rofessional trainin&0

(iii) +ork e,erience o@er and ao@e

ad@ertisement) Eenclose a se,arate sheet0

dul# authenticated # #our si&natures0 if

the s,ace is insufficient :_________________________________

1. an&ua&e kno+n (4ead0 +rite0 s,eak and

understand) :

__________________________________

DECLARATION

> here# solemnl# declare and undertake that all information furnished # me is true0

correct and com,lete to the est of m# kno+led&e and elief. > also undertake that0 if at an#

sta&e of selection0 the information furnished is false or misleadin&0 m#

candidature/a,,ointment/ser@ices +ill stand cancelled/terminated +ithout assi&nin& an#

reasons there for.

"ate: __________ 8i&nature: ____________

*lace: ___________ Name : ______________


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Note: %ttested co,ies of documents in su,,ort of educational Dualification and e,erience

must e enclosed. %,,lication +ill not e considered +ithout attested co,ies of all su,,ortin&

documents.

Manager Pist

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