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 Appointment as Young Professional

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. Communication Address

10.Date of Joining in Govt. Service(if any)

11. Name of the Ministry/PSUs /Department/other

12. Academic & Professional Qualification

Qualification possessed	Board/University	Passing Year	Percentage

13. Details of Knowledge of Computer

14. Work Experience

Designation	Organization	Period	Key tasks accomplished

15. 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.