CORPORATION OF CHENNAI, RIPON BUILDING, CHENNAI

Transcription

1 CORPORATION OF CHENNAI, RIPON BUILDING, CHENNAI APPLICATION FOR THE POST OF ASSISTANT ENGINEER (MECHANICAL) / (CIVIL) / (ELECTRICAL) & SANITARY INSPECTOR APPLICATION FOR THE POST OF 1.Name in full (Block Letters) 2.Father s / Husband s Name Affixed Photo should be attested by the gazetted officer 3.Gender (Tick the relevant box) 4.Maritual Status (Tick the relevant box) Male Female Third Gender Married Unmarried Widow 5.Full Postal Address with Mobile No. & -id a) Permanent Address: Pincode: District: Mobile No: -id: b) Address for correspondence Pincode: District: Mobile No: -id: 6.Nationality : Religion : 7. a) Date of Birth : b) Age : D D/ M M/ Y Y Y Y (Self attested copy of High School Certificate showing Date of Birth must be enclosed) 8.a) Mother tongue : (Please mentioned if Tamil is not mother tongue) b) Second Language in School :

2 9.Category [SC(A)/SC/ST/MBC/BC/BC(M)/OC] : (Self attested copy of Caste Certificate to be enclosed) 10.EDUCATIONAL QUALIFICATION (Self attested copy of all Educational Qualifications to be enclosed) Sl.No. Qualification Register No. Year of Marks, Grade Nam of the Institution Passing obtained with class Grade % Class 1. SSLC / MATRIC 2. HSC 11.PROFESSIONAL / TECHNICAL QUALIFICATION (Self attested copy of Certificates as Proof) Sl.No. Qualification Register No. Year of Marks, Grade Name of the Institution Passing obtained with class 1. Grade % Class a) Wheather Ex-servicemen b) If yes, please furnish the detail and enclosed self attested copy of discharge certificate Date of Entry in Armed Forces Date of Discharge Number of Years Service rendered 13.Wheather Destitude Widow : (YES / NO) 14.If candidate belonging to Differently abled persons : (YES / NO) Type of PH Percentage of PH Certificate No. Name of Issuing and Date Medical Authority 15.EXAMINATION FEES DD No. Date Name of the Bank & Branch Amount

3 16.OTHER DETAILS, IF ANY Note : Stage of the case at the time of applying, Nature of the criminal charge, if acquitted on the date of this application date of judgement should be given. (Tick the relevant box) Section of Law Pending Stage of Case YES NO Acquitted YES NO Date of Acquitted D D M M Y Y Y Y PARTICIPATION IN POLITICAL In agitation YES NO As member of Political YES NO Organisation Candidate in Election YES NO Note : Qualification for the post : 1) Assistant Engineer (Mechanical) : A degree in Mechanical Engineering / B.Tech (Mechanical ) / Auto Mobile Engineering /Mechatronics Engineering OR A pass in Sections A and B of the Institution Examinations (A.M.I.E) under Mechanical Engineering Branch 2) Assistant Engineer (Civil) : B.E. Civil Engineering /B.Tech(Civil)/B.E. Structural Engineering OR A pass in Sections A and B of the Institution Examinations (A.M.I.E) under Civil Engineering Branch. 3) Assistant Engineer (Electrical) : A Degree in Electrical Engineering/ Electronics and Communication Engineering / Information Technology / Instrumentation Engineering / Computer Science OR A.M.I.E under Electrical Engineering Branch. (Recruitment for the Degree in Electrical & Electronics Engineering - Degree in Electronics and Communication - 14 Vacancies 5 Vacancies Degree in Instrumentation Engineering - 2 Vacancies Degree in Information Technology / Degree in Computer Science) - 2 Vacancies

4 4) Sanitary Inspector a) Must have minimum qualification of B.Sc. Degree (main subject Chemistry) from the Recognized Institution approved by Government. b) P.G. Diploma in Sanitary Inspector course conducted by the Institutions recognized by the Government. c) Certification in Computer course. Check list of Enclosures (Tick the relevant Column) Sl.No. Documents Yes No Not applicable 1. Passport size photos (Colour) 3 Nos (1 pasted on application form, 1pasted on hall ticket and 1to be enclosed with application 2. Date of Birth (SSLC / Matric passed Certificates) 3. Educational Qualifications 10th (Certificates & Marksheets) HSC Degree 4. Community Certificate [SC(A)/SC/ST/MBC/BC/BC(M)/OC] in prescribed proforma 5. No Objection Certificate (in case of Departmental candidates) 6. Differently abled persons Certificate in prescribed proforma for Employment in State Government 7. Discharge Certificate (in case of Ex-servicemen) 8. Whether all above documents / certificates are self attested Date : Place: Signature of the Candidate

5 DECLARATION I hereby declare that all the statements made in this application are true and correct to the best of my knowledge and belief. In the event of any information being found false / incorrect or ineligibility deducted before or after the written test / certificate verification or even after appointment, my candidature / appointment will stand automatically cancelled. Date : Signature of the Candidate