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RECRUITMENT IN M.P. DAY STATE RURAL LIVELIHOOD MISSION
Fields marked with * are mandatory
Instructions
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
Examination City Center Name 1 Examination City Center Name 2 Examination City Center Name 3
Applicant's Name*
Father's/Husband's Name*
Mother's Name*
Domicile of MP:*
Category:*
Nationality:*
Marital Status:* Are You an Ex Serviceman*
No. of Children Last child birth date (In DD/MM/YYYY) Is Your Last Child Born Twins
Gender*
Date of Birth(DD/MM/YYYY)* (In DD/MM/YYYY) Age as on 28/02/2019    - -(yy-mm-dd)
Are You Physically Handicapped ?*
Type Of Physically Handicapped
Educational Qualification
*
Qualification Name of the Degree Passing Year University/Board Institute/College Name Obtained Percent (In 00.00 Format)
10th* 10th
12th* Higher Secondary
Graduation*
Post Graduation*
Others
* 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%.
Experience Details
During the service in NRLM, Candidate was terminated or discontinued from his/her Service(Agreement Not Renewed) by the department UNDER National Rural Livelihood Mission?*
Reason Date(dd/MM/yyyy)
Do you have Minimum 3 years continues working experience for the post of Assistant District Manager / Accountant Under Scheme of Panchayat and Rural Development Department?*
*
Organization Name Field Name Department Type From date (In DD/MM/YYYY) To date (In DD/MM/YYYY) Total experience
    YY 0 MM 0
    YY 0 MM 0
    YY 0 MM 0
    YY 0 MM 0
    YY 0 MM 0
Total work Experience in Years-Month :- 0 -0
Communication Address
Address*
State* City/Town* Pin No.*
Email id* Mobile No.*   Phone No.  
Permanent Address(Same as Communication Address)
Address*
State* City/Town* Pin No.*
Mobile No.* Phone No.
Attachment*
Attach Photo with Signature*
Click here for photo sign format
Declaration *
I HEREBY DECLARE THAT ALL THE INFORMATION GIVEN IN THE AFOREMENTIONED APPLICATION FORMAT IS TRUE TO THE BEST OF MY KNOWLEDGE. I UNDERTAKE AND ACCEPT THAT IF ANY OF THE INFORMATION GIVEN BY ME IS FOUND TO BE INCORRECT, THEN MY APPLICATION WILL BE REJECTED AND IF APPOINTED, THEN MY APPOINTMENT WILL BE TERMINATED & ACTION MAY BE TAKEN ACCORDINGLY.