Application Form

Application Number
Token / Transaction

: 100360104670586
: 1499099910457255

1. Exam Details
1.1 Examination Name
1.2 Examination Post
1.3 District Head Quarter for Exam
1.4 General Subjects (PRE)

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1.5 Optional Subjects (PRE)

1.6 General Subjects (MAINS)

1.7 Optional Subjects (MAINS)

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1.9 Medium Of Exam

Payment Mode : E-Mitra

Application Filled Date

Reference Application

: 11/08/2014 10:50 PM
: 100360104670586

LECTURER ELECTRONICS ENGG TECH EDU 2014

LECTURER ELECTRONICS ENGINEERING
AJMER
ELECTRONICS ENGINEERING

2. Department Preferences
2.1 Department Preference

3. Applicant's Details
3.1 Applicant's Full Name
3.2 Applicant's Father Full Name
3.3 Applicant's Mother Full Name
3.4 Date Of Birth (dd/mm/yyyy)
3.5 Gender
3.6 Marital Status
3.7 Category
3.8 Home State (Bonafide Resident)
3.9 Home District

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HARIMOHAN MEENA
BHARMAL MEENA
MOTYA DEVI
05/07/1990
MALE
Unmarried
ST
RAJASTHAN
TONK
Photo & Signature
Of Candidate

4. Other Special Categories

4.1 Category for Disabled Candidates
4.2 Specific Category for Female
4.3 Other Category

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5. Correspondence Details
5.1 Address

5.2 Email
5.3 Phone
5.4 Mobile
6. Qualification

: VILLAGE-KUNDIYA POST-BALITHAL TEH.-UNIYARA DIST.-TONK,

BALITHAL,Tehsil : UNIARA,City/Village : KUNDIYA - 304024
Dist : TONK, State : RAJASTHAN
: HM050790@GMAIL.COM
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: 7531054715
Year

6.1 Secondary
6.2 Sr. Secondary
6.3 Graduation
6.4 Post Graduation
7. Additional Qualifications/Specifications
7.1 Other Specification/Qualification
7.2 Examination passed
7.3 Internship Period
7.4 Experience
8. Identification
8.1 Body Mark
9. Disclaimer

: 2006
: 2008
: 2013
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Division/Grade

First
First
First

Passed

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Months :

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: CUT MARK ON KNEE

I hereby declare that all information made in this application are true, complete and correct to the best of my knowledge and belief. In the event of my information being found false or incorrect or the ineligibility
being detected before or after the Screening Test/Interview, action can be taken against me by the Commission. I have read the provisions of the relevant rules and the Advertisement carefully and I hereby
undertake to abide by them. I further declare that I fulfill all the conditions of eligibility regarding age limits, educational qualification and required experience etc. prescribed for admission to the Screening
Test/Interview. Also I accept SMS facility provided by the Commission.

Imp. Note - Candidates are advised to make permissible corrections on-line, on RPSC Online portal, using Edit facility with-in 30 days from last date of application submission. No
further online corrections would be accepted by RPSC in any case.(Refer General Instructions for Applicants on RPSC Online Portal/RPSC Web site.)
Rajasthan Public Service Commission
Ghooghara Ghati, Jaipur Road, Ajmer
Phone : +91+145+ 5151200, 5151240 & 5151090
Help Line : 0145-5151212

Nodal Officer: Mr. Akhilesh Mittal, System Analyst (Joint Director)