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University Name Jawaharlal Nehru Krishi Vishwavidyalaya, Jabalpur
Post Field Extension Officer( प्रक्षेत्र विस्तार अधिकारी )
Personal Details
Applicant's First Name* Applicant's Middle Name Applicant's Last Name*
Father's First Name* Father's Middle Name Father's Last Name*
Mother's First Name* Mother's Middle Name Mother's Last Name*
Category:* Nationality:* Domicile Of MP:*
Gender* Marital Status* Ex Serviceman (Defence Personnel):*
No. of Children* Last child birth date* DD/MM/YYYY Is Your Last Child Born Twins ?*
Date Of Birth* DD/MM/YYYY Age as on 01/01/2016 - -(yy-mm-dd)
Are You Physically Disabled ?*
Are you 40% Disabled ?* Physically Disability Type*
Educational Qualification
Qualification Name of the Degree  Passing Year University/Board  Institute/College Name (% of Marks)
10th* High School
12th/Diploma* Higher Secondary
Degree*
*If 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%.
If the Result of Exam has not declared then candidate has to be enter past year result details.
Working Experience 
Do you have work experience in Government/Government Owned/PSU Organization / Nigam / Mandal *
Company Name Company Type From date DD/MM/YYYY To date DD/MM/YYYY Total experience
    0YY 0MM
    0YY 0MM
    0YY 0MM
    0YY 0MM
Whether Employee presently in Government/Government Owned/PSU Organization Nigam/Mandal *
* If yes, NOC from the organization will need to be produced at the time of Joining.
Communication Address  
Address*
City/Town* District* State*
Pin No.* Email Id* Mobile No.*
Phone No.
Permanent Address(Same as Communication Address)
Address*
City/Town* District* State*
Pin No.* Mobile No.* Phone No.
Attach All Document's  (Only .jpg document Allowed(max Allowed size is 200kb)
Attach Photo with Signature *
Upload Photo Identity Proof(Passport /Driving License / Voter Id Card/Pan Card / Aadhar Card)*
Upload Higher Secondary / High School Examination Certificate / marksheet,its support date of birth *
Upload Domicile Certificate*
Upload Cast Certificate *
Degree*
Handicapped Certificate *
 
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.