Application Form
Application for the post(Mention Below)*
---Select option---
House Mother/Father
Paramedical Staff
House Keeper
Manager/Coordinator
Nurse
Doctor
Ayah
Chowkidar
Applicants Name(In Block Letters)*
Passport Photo
*
(Only accepted JPG, JPEG, PNG & GIF format)
Addresss For Correspondence
Permanent Address
Phone No
Email Id
Adhar Number
Date of Birth
Gender
Male
Female
Other
Marital Status
Mothers Name
Fathers Name
Educational Details
Qualification
Name of Qualification Awarded
Duration From
Duration To
College/University
%of Marks Secured
Subject Studied
Full Time/Part Time/Distance
Educational Proof
Matriculation
Intermediate
Graduation
Post Graduation
Other
Employment Details
Name of the organization
Designation
Key Responsibility Handled
Duretion From
Duretion To
Employment Certificate
Current Employment
Name Of the organization
Designation
Responsibility handled
Working From
Monthly Remunuration
Employment Certificate
Computer Literacy
Package/Application
Details of Exposure/Proficiency
Language Proficiency
Language
Ability to speak
Ability to Read
Ability to Write
English
Poor
Fair
Good
Poor
Fair
Good
Poor
Fair
Good
Hindi
Poor
Fair
Good
Poor
Fair
Good
Poor
Fair
Good
Oriya
Poor
Fair
Good
Poor
Fair
Good
Poor
Fair
Good
I hereby declare that the foregoing information is correct, genuine and complete to the best of my knowledge and belief and nothing has been concealed of distorted.
Submit