1

EWING CHRISTIAN COLLEGE, ALLAHABAD

(An Autonomous Constituent College of Allahabad University)
(A CHRISTIAN MINORITY INSTITUTION OF THE CHURCH OF NORTH INDIA)

APPLICATION FORM FOR NON-TEACHING POSTS

Name of the post applied: ______________________________________________

Advertisement No.: ________________________________ dated ______________


Details of Demand Draft:


Amount
(Rs.)
D.D. Number Banks Name









FOR OFFICE USE ONLY

Name of the Candidate :
Eligible / Not Eligible :




Date:



Member Member Member CHAIRMAN

S C R U T I N Y C O M M I T T E E
REGN. No.


Paste a recent
colour
passport size
photograph
here
2

1. (i) Name (in block letters) _______________________________________________________

(ii) Male/Female __________________________ (iii) Marital status __________________

2. Fathers Name (in block letters) ________________________________________________

3. Post applied for _________________________________________________________________

4. Date of birth ___________________ Age (as on date): Years _______ Months ________

5. Nationality ______________________________ Religion ______________________________

6. Address (In Block Letters only):

Permanent address

_________________________________

_________________________________

_________________________________

_________________________________

PIN CODE: _____________________

Contact: _______________________

Present address for correspondence

_________________________________

_________________________________

_________________________________

_________________________________

PIN CODE: _____________________

Contact: _______________________

E-mail: _________________________


7. Details of educational/technical qualifications:
(From Matriculation onwards)

Examination
Passed
Year of
passing
University/Institution
Division
with %
Subject taken and passed
Proof
furnished
(Encl. No.)

Class X



Class XII



Graduation




Post-
graduation



Any other


3

8. If you are employed furnish the particulars of all posts held to date:

Name of the post
held and nature of
employment
Name of Employer and
address
Period of service Length of service
Scale of
pay &
salary
drawn
Proof
furnished
Encl. No.
From To From To







9. Are you physically handicapped (VH or OH)? (If so, attach a disability certificate from a
government hospital)
(YES/NO)
_________________________________________________________________________________

10. State details of present salary:

a) Scale of Pay : Rs._____________________________________
b) Present Basic Pay : Rs._________

c) D.A. : Rs._________
d) H.R.A. : Rs._________
e) C.C.A. : Rs._________
Date of Next Increment _________
Total salary per month: Rs.____________

11. State in brief, the nature of duties assigned/performed: (Use separate sheet, if necessary)

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________
12. Are you a permanent or Temporary Govt./Quasi Govt./Public Undertaking/
University/College Servant?
If yes, give the particulars of the post held _____________________________________________
4

13. State whether you have been at any time (a) Dismissed, removed or debarred from Service
or (b) convicted by a Criminal Court.

__________________________________________________________________________________


14. Give one page report (handwritten) on why you want to join Ewing Christian College and
if selected how you wish to serve the institution apart from your regular assignments.

(Attach Separate Sheet)


15. Give the names of two responsible persons not related to you to whom a reference can be
made about you. Also give their addresses, Contact No & E-mail.

1. ______________________________________________________________________________

______________________________________________________________________________

2. ______________________________________________________________________________

______________________________________________________________________________

16. Declaration to be signed by the candidate:

I hereby declare that all the entries made in this application are true to the best of my
knowledge and belief.

Place____________ Signature __________________________
Date_____________ Full Name__________________________

(The endorsement below is to be signed and forwarded by the Head of the Department/Employer
in the case of the in-service candidates whether in permanent or temporary capacity failing which
the application is liable to be rejected.)

FORWARDED

No._____________

The applicant Shri/Smt./Km./Dr___________________________________ holds the post of
__________________________ in this University / College / Institution / Organization in a
temporary / permanent capacity with effect from _____________ in the scale of pay of
Rs.___________________________. He/She is drawing a basic pay of Rs.__________ total
emoluments of which are Rs._________________ as on date ________________. His / Her next
increment is due on _______________. There is no objection for his/her application being
5

forwarded and in case if he/ she is selected to the post, he/she will be relieved from the service of
this Institute.
Signature of the forwarding Officer

Designation


(Seal)
Date: ________________

Place: ________________

PLEASE NOTE:

1. Only Forms sent through registered post along with a draft of Rs. 200/- drawn in favour of
The Principal, Ewing Christian College, Allahabad payable at Allahabad will be accepted.
No forms will be received directly at the College Office.
2. Only hand-written forms will be accepted
3. Please use the space provided. Do not use additional sheets except where specifically noted
and needed.
4. Self-attested copies of certificates, mark sheets, testimonials to be attached. Originals must be
brought at the time of the interview.
5. Those in employment should send their applications through their employers, though an
advance copy may be sent directly.
6. No TA/DA will be paid to Out-station candidates who are called for interview.
7. Last date for accepting the filled-up application forms in the College Office is September 10, 2012. No
form will be accepted after September 10, 2012 and College will not be responsible for any
postal delay.