Date of Birth: Age in Years: Place of Birth:

Gender:   Male   Female   Transgender      Guardian Type:   S/O   D/O   W/O   C/O

Name of Father/Guardian : Mother’s Maiden Name :

Ration Card No. : Aadhaar No. :

Caste Category :   GEN   SC   ST   OBC   NA

Physical Disability:   YES   NO IF YES   Hearing Impaired   Visually Impaired   Other

Religion:   Hindu   Muslim   Christian   Sikh   Buddhist   Jews   Other

Mother Tongue :      Marital Status :   Single   Married

Taluka: District: State:
PIN Code: Permanent Address:

Same as above:

E-mail ID: Contact Number :

Previous Experience: Year: Months :

Education Level:   Un-Educated   Under Graduate   Graduate   Post Graduate   ITI   Polytechnic   Diploma

Technical Education:   Yes   No    Please Specify Qualification :

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