Application Proforma

भारतीय पुनर्वास परिषद्
(सामाजिक न्याय और अधिकारिता मंत्रालय का एक सांविधिक निकाय)
दिव्यांगजन सशक्तिकरण विभाग
भारत सरकार
REHABILITATION COUNCIL OF INDIA
(A Statutory Body of Ministry of Social Justice and Empowerment)
Department of Empowerment of Persons with Disabilities (Divyangjan)
Government of India

Application for engagement of Hindi Officer Consultant(Contract)

Scanned Recent Coloured Passport Size Photograph in.jpg
format size below 200 kb. ★
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1. Applicant's Full name ★

2. Father's name ★

3. Gender ★

4. Date of Birth ★

5. Category ★

6. whether belongs to PwD ★

7. Email ★

8. Mobile number ★

9. Aadhaar No ★

10. Address ★

11. Academic & Professional Qualification ★

Qualification possessed	Board/University	Passing Year	Percentage/CGPA

12. Experience ★

Department/Organization Name	Department/Organization Type	Post Held & Pay Scale	From	To	Nature of Duties	Experience In Year

13. Details of courses/ training programmes attended,if any

14.Details of present/Past employment

15. Total emoluments drawn per month

16.In case the present employment is held on deputation / contract basis,please state
Date of initial appointment

17. Period of appointment on deputation/ contract

16. Additional details about present employment

18. upload documents: ★

1.Signature *Click Here to Upload

2.All documents relating to DOB,Academic,Professional Qualification and experience certificate etc.(single pdf file size not more than 5 MB) to be uploaded duly signed. ★ *Click Here to Upload

Enter the text image. *

I have carefully gone through the Vacancy circular/ advertisement and undertake that information/details furnished above are correct to the best of my knowledge. I also understand that my candidature to the post applied for liable to be cancelled,if any of the above information is found to be false or incorrect.