KMSCL

Affix Recent Photograph of the Candidate

APPLICATION FORM Please fill this application form accurately. Incomplete forms may lead to disqualification from selection process.

All fields marked * are mandatory Position Applied for: Advertisement No. & date :

1. Name*

Gender* M / F

Age* ____Years Date of Birth* _ _ __/__ __/ __ __

2. Mailing Address* Present Address:

Email

Permanent Address

Mobile Number _____________________ Present Residence Telephone No. ___________________ Permanent Residence Telephone No. (With City Code)____________________________________________

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Application Form| KMSCL | 2012

3. Educational Qualification*:

Educational Degree

Year of Completion (mention if pursuing)

Subjects / Stream

Grade %

Please specify if Open School/ Part Time / Correspondence / Regular

4. Technical Qualification (If any) Certification

Institution

University/Board

Percentile/Grade (if applicable)

5. Work Experience* Have you worked earlier? Yes / No (If no, then move on to the next section)

Employer’s Name

Designation

Period Worked(dd/mm/yy) From

Nature of assignment

To

Last pay drawn

Reason for Leaving

2828

Total Relevant Experience

_____Years ____Months Page - 2 - of 3

Application Form| KMSCL | 2012

6. Have you applied for any post in KMSCL before?* Yes No

,If Yes mention the post and year applied________________________________

7. Is there any of your immediate relatives working in the corporation?* Yes No

8. Reference Details* Reference Name*

Company Name

Designation

Contact Number

Email Address

Years of association

1 *How do you know the reference:

2

*How do you know the reference:

The information I have given on this application form and all the documents submitted along with this is, to the best of my knowledge and belief, true and complete. I understand that any false or misleading statement made here constitutes grounds for my application to be rejected.

Signature of the candidate

Date:

___________________

For Office use only.

Accepted

Rejected

Status

:

Reason for rejection

: ________________________________________________________________

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Application Form| KMSCL | 2012