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Fields marked with * are mandatory
Documents to be furnished in original at the time of verification of documents along with one set of photocopies attested by a Gazetted officer and a copy of online submitted application form / Receipt
Personal Details
Applying for Post *
Applicant's Name*
Father's/Husband's Name*
Mother's Name*
Date of Birth(DD/MM/YYYY)* Age as on 01/01/2019    - -(yy-mm-dd)
Are You Handicap?*
Are you Domicile of MP? *
Employment Registration No. *
Are You an Ex Serviceman*
Type of Handicap?*
Marital Status
Marital Status:* No. of Children
Last child birth date (In DD/MM/YYYY) Is Your Last Child Born Twins?
Educational Qualification
Qualification Name of the Diploma Stream Passing Year(YYYY) University/Board Institute/College Name Total Marks Obtained Marks Obtained Percent
10th* 10th  
12th* Higher Secondary
Diploma in Computer from recognized University/Institute by U.G.C.*
* In case your University/Institute does not award marks, please convert grades(CGPA) to Percentage marks and fill.
* Write % of marks with two digits after the decimal. The second digit after the decimal should be rounded off. e.g., if Marks is 60%, then write 60.00%. If marks are 68.938% then write 68.94%.
CPCT Exam Information*
Passing Year (YYYY)  Total Marks  Obtained Marks Hindi Typing (WPM) English Typing (WPM)
Result Result Result
Work Experience
Are You Serving in State Government/Corporation/Board on the Contract Term? (If so, the applicant appointment order is compulsory to attach)
Do you have Knowledge of English and Hindi Typing?*
Do you have Knowledge of Data Feeding?*
Do you have Knowledge of Document scanning?*
Do you have 3 Years Experience in Ms Office and Database Software?* (Experience Letter is compulsory to attach)
Communication Address
State* District* PinCode.*
Email id* Mobile No.*   Phone No.  
Permanent Address(Same as Communication Address)
State* District* PinCode*
Mobile No.* Phone No.
Bank Details
Account Number Bank Name
Account Holder Name IFSC Code
Photo with Signature*
Click here for photo sign format
Read form carefully before submission.*
I, hereby declare that the above details are true, correct and complete in all respects to the best of my knowledge and belief and nothing has been concealed and in the event of any information being found false/fabricated or any deficiency in the eligibility of the post being detected at a later stage, my candidature is liable to be summarily cancelled/rejected.