RAJIV GANDHI UNIVERSITY (A CENTRAL UNIVERSITY ) RONO HILLS, DOIMUKH 791112 ARUNACHAL PRADESH

APPLICATION FORM FOR THE POST OF LDC, UDC & STENOGRPHER GRADE-III (Please type or write in black ink) 1. 2. 3 4. Registration No.(to be filled by the office) Advertisement No. & date POST APPLIED FOR NAME IN FULL (in block letters) MR./MRS./MISS/.. .. SURNAME
Paste here a signed copy of your recent passport size Photograph

5. 6. 7. 8. 9. 10. 11 12. 13.

Fathers

name

Mothers name Telephone/ Mobile Number Email ID Date of Birth & Age as on 1/5/2013 Mailing address with PIN code Permanent address with PIN code Place of birth Academic Qualifications (please attach attested copies of certificates)
Degree/Examination University/Institution Year Discipline

Vill./Town.. Dist. State

Division/ Class

% of Marks

Rank in Board/University

14.

Whether belongs to (attach attested copy of certificate) : a. Scheduled Caste b. Scheduled Tribe c. Other Backward Class

(X) cross which is not applicable Yes Yes Yes / No / No / No

d. Persons with Disabilities 15. 16. 17. 18. . i. ii. iii. iv. v.

Yes

/ No

Technical or any other qualifications possess, (if any) Particulars of Demand Draft (i) No. & Date (b) Amount `.. Anything else not covered above, please attach additional sheet if the space is not sufficient. LIST OF ENCLOSURES

19.

I hereby declare that the entries in this form are correct and true to the best of my knowledge and belief. If at any time, I am found to have concealed/suppressed any materials/information or given any false details, my candidature shall be liable to be summarily rejected without notice or compensation.

Date : Place :

Signature of the applicant

20.

(APPLICABLE IN CASE OF IN SERVICE CANDIDATES ONLY)

To be filled in by the forwarding authority :

Dated ..

Forwarded to the REGISTRAR, RAJIV GANDHI UNIVERSITY, RONO HILLS, DOIMUKH 791112, ARUNACHAL PRADESH The applicant has been working in this office/organisation as since .and is still in service. We have no objection to his candidature being considered for the post he is applying.

Date : Place :

Signature : .. Designation : ..

The completed application should be submitted to : THE REGISTRAR, RAJIV GANDHI UNIVERSITY, RONO HILLS, DOIMUKH 791112, ARUNACHAL PRADESH

N.B :
A. Application needs to be submitted in duplicate along with recent passport size photos 4 copies and Photostat copies of all supporting documents, and non-refundable application fee of Rs. 200/(exempted for SC/ST candidates) through Demand Draft drawn in favour of the Registrar, Rajiv Gandhi Univerisity, Rono Hills, Doimukh - 791112 payable at State Bank of India, Itanagar or Vijaya Bank, Doimukh (others than are not acceptable) should reach the Registrar, Rajiv Gandhi University, Rono Hills-79112, Doimukh, on or before 16/7/2013 . The envelope should superscribe the post applied. Application (s) received after the last date or incomplete in any form or without the application fee, shall be summarily rejected. Those in employment must apply through proper channel or furnish No Objection Certificate from the employer concerned. The University reserves the right not to fill any or all the posts advertised B. 1. Other Backward Class (OBC) must submit certificate belonging to NON CREAMY LAYER Issued by appropriate authority. 2. The Contractual & Contingency employees working in Rajiv Gandhi University, Rono Hills, Doimukh must furnish No Objection Certificate from the Registrar. 3. No TA/DA will be paid for attending the interview, if called for. 4. The University will not be responsible for non-receipt of application or any delay in receipt Thereof on any account. 5. Those who have applied for the post of UDC & Stenographer Grade-III earlier in response To this University advertisement of even number dated 3/2/2012 need not to submit a fresh Application fee but should the correct details of draft already submitted by him/her along With the earlier application. 6. Canvassing in any form shall lead to disqualification in appearing interview.

Sd/REGISTRAR