Government Polytechnics

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Designation*

Basic information

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First Name *

Middle Name

Last Name*

Salutation *

Gurdian First Name *

Gurdian Middle Name

Gurdian Last Name*

Category*

Issuing Authority*

Date of Issuing Certificate*

Certificate No*

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EC Issuing Authority*

Date of Issuing EC Certificate*

EC Certificate No*

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Religion*

Nationality*

D.O.B*

Age As On 01.01.2024

EWS*

Gender*

Id Type*

PwD(Blindness or low vision/Hearing Impairment/Locomotor disability or cerebral palsy)

Yes No

Address for Communication

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Post Office

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Permanent Address

Same as Present Address

House / Flat / Building / Plot*

Street Name*:

Post Office

Police Station

State*

District*

Subdiv*

Block / Municipality*

Pincode *

Contact Information

Primary Contact No*

Secondary Contact No

Email*

educational qualification

PhD

Stream / Specialization

College / University Name

Year of Passing

Post Graduation

Degree*

Stream / Specialization*

College / University Name*

Percentage*

Year of Passing*

Graduation (Note: Only candidates enrolled for Associate member of Institution of Engineers (AMIE) upto 31/05/2013 are eligible.)

Degree*

Stream / Specialization*

College / University Name*

Percentage*

Year of Passing*

Class/Division*

12th / Higher Secondary / Diploma Engineering

Stream / Specialization*

Board*

CGPA / GPA / Percentage*

Year of Passing*

10th / Secondary

Board*

CGPA / GPA / Percentage*

Year of Passing*

Upload Computer Certificate (Please provide pdf within 200KB)*
(Note: Acquisition of elementary knowledge of computer operation with the ability of typing on computer at the speed of 20 words per minute in English and 10 words per minute in Bengali from a reputed organization for a period not less than 6 (six) months.)

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8th / Class VIII

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Experience

Name of Organization*

Designation*

Date of Joining*

Date of Resigning*

Current Organization

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Upload Signature* (Please provide jpg / jpeg within 20KB)

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Upload Experience Certificate (Please provide pdf within 200KB)

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Declaration : I hereby declare that, all the above information furnished by me are true to the best of my knowledge. Authority may reject my candidature / application at any point of me, if any discrepancies found.

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Post Applied For

Basic information

Address for Communication

Present Address

Permanent Address

Contact Information

educational qualification

PhD

Post Graduation

Graduation (Note: Only candidates enrolled for Associate member of Institution of Engineers (AMIE) upto 31/05/2013 are eligible.)

12th / Higher Secondary / Diploma Engineering

Diploma / ITI / Certificate

10th / Secondary

8th / Class VIII

Experience