|| ON-LINE APPLICATION FORM ||
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Service Applied For
:
Advt. No 06/2010 dt 01/05/2010
Service Chosen in Order of Preference
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Preference :
TCS Grade-II
TPS Grade-II
Personal Information
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Name of the Applicant :
Select
Mr.
Miss.
Mrs.
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Father's Name :
Select
Mr.
Late.
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Mother's Name :
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Mrs.
Late.
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Permanent Address :
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Postal Address for Communication :
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Date of Birth :
Day
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01
02
03
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05
06
07
08
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11
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Month
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January
February
March
April
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July
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September
October
November
December
Year
Age :
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Upload Applicant's Image :
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Sex :
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Male
Female
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Whether Differently abled (PH) :
(at least 40% disability)
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Yes
No
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Category :
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Others
SC
ST
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In case of ST/SC, whether the certificate has been issued by Appropriate Authority of the Govt. of Tripura :
Select
Yes
No
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Contact Telephone Number :
Land Line :
(if no, quote'0')
Mobile :
(if no, quote' 0')
Educational / Other Qualifications
Must hold
Bachelors Degree of a recognized University
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Name of the Examination :
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Name of the University :
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Year of Passing :
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Percentage of marks obtained :
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Any other Qualifications suitable for the post :
Subjects / Papers for appearing in the Competitive Examination
Compulsory Paper-I :
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Optional Paper-I :
Compulsory Paper-II :
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Optional Paper-II :
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Compulsory Paper-III :
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Optional Paper-III :
Compulsory Paper-IV :
Compulsory Paper-V :
Miscellaneous Details
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Whether currently employed in regular Govt. Service :
Select
Yes
No
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Whether Ex-Serviceman :
Select
Yes
No
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If yes, period of Service :
(years)
(if no, quote'0')
(months)
(if no, quote'0')
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Experience, if any :
Bank Details
Recruitment Fee Deposited in the Account No.
14711
of the Tripura Gramin Bank or
31110220136
of the State Bank of India in favour of
The Secretary, Tripura Public Service Commission, Agartala.
Deposited through
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Bank Name :
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Branch Name :
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Fee Deposit Date :
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Amount
(Rs.)
:
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