PDF - Rajiv Gandhi National Institute of Youth Development

RAJIV GANDHI NATIONAL INSTITUTE OF YOUTH DEVELOPMENT
(Institute of National Importance by the Act of Parliament No. 35/2012)
Sriperumbudur –602 105.(Tamil Nadu),Website : www.rgniyd.gov.in
1. Name of the Applicant:
2. Personal status: Married
3. Sex: Male
Female
4. Category: SC
ST
Self attested
PP Size
photograph
Unmarried
Transgender
OBC
GN
5. Date of Birth
Date
6. Nationality
7. Name of Father :
8. Name of Mother :
9. Address for communication
Pin code
Mobile No.
Email id :
Fax No.
Permanent
Pin code
Month
Year
10. Present Employment:
Current Designation
Organization Name &
Address
Pay Band and Grade Pay
Date of entry to the Grade
Pay
Pay in Pay Band
Total monthly emoluments
11. Educational Qualification (Starting with Matriculation):
Course
School/College/ University/
Institution
Year of
Joining
Year of
Leaving
Percentage
of marks
Class/
Division
Date &
Year of
Joining
Date &
Year of
Leaving
Percentage
of marks
Class/
Division
12. Professional Training
Course
School/College/ University/
Institution
13. Employment Record in chronological order, ending with present job:
Name and Address of
Organization
Designation
Dates
Period
(MM-YY)
From
To
Pay
Scale/Grade
pay
14. Names and Addresses of three referees:
1
Name
Occupation
or Position
Address
Phone No.
Mobile No.
E-mail
Fax No.
2
3
Nature of
Duties
15. Write Up :
One page write-up of your appreciation of the role and functions of the position and your
appreciation of how you can contribute to the Institute as well as why you consider yourself to
be suited for the post.
Maximum 300 words
16. Any other relevant details
List of Attachments: Self attested photo copies of certificates/ testimonials.
(to be enclosed along with the print out of the online /PDF submitted application). Please tick
mark against attached documents)
I.
Proof of date of birth (SSLC Marks Card)
II.
Self-Attested copies of Educational qualification
III.
Attested copies of SC/ST/OBC/PH certificates
IV.
One page write-up
V.
Through proper channel
VI.
Any other information
Total number of sheets excluding main application
I hereby declare that the information given above is true and correct to the best of my knowledge and
belief and I fully understand that if it is found at a later date that any information given in the
application is incorrect / false or if I do not satisfy the eligibility criteria, my candidature/ appointment is
liable to be cancelled / terminated.
Date:
Signature of the Candidate
The application with all relevant enclosures should reach on or before 30th April 2015 to The Director
Rajiv Gandhi National Institute of Youth Development, Sriperumbudur-602 105 (Tamil Nadu)