Application Form

Social Welfare Department (ICDS), Govt. of Bihar

Application for Contractual Recruitment of Lady Supervisor
Application Details
Application ID :     LSP/0142028 Application Date :
Post Applied For : Lady Supervisor
17-Jul-2019

Personal Details
Applicant Name NICE SINGH
Father's /Husband's Name JITENDRA SINGH
Mother's Name Rinki singh
Date of Birth 27-Mar-1997
Age as on (01.01.2019) 21 Years 9 Months
Gender Female
Marital Status No
Category GEN
Nationality Indian
Physically Handicapped No
Catagory of Physically Handicapped
Percentage of Physically No
Handicapped
Grand Children of Freedom Fighter No
Email ID kaushiknice77@gmail.com
Mobile No. 9304314171
Phone With STD Code
Aadhar No XXXXXXXX2101
Identification Marks Near Royal Enfield show room
Do you know read/write hindi Yes
Do you have minimum qualification Yes
as defined in Advertiesment
Reference of known person with Name: Sanjay Singh address: lalpur ranchi state: jharkhand
address who has seen Your Work
[Last Six Month] (1)
Reference of known person with Name: Vikash address: morabadi ranchi state: jharkhand
address who has seen Your Work
[Last Six Month] (2)
If any Criminal No
Proceedings[Aapradhik Mukadama]
Against You has been Initiated ?
Are you Employee of Bihar No
Govenment
Designation
Office
Place

Address for Correspondence

Address Aam bagan basti po: sonardih ps: madhuban district : dhanbad state : jharkhand
Pin Code 828125

Permanent Address
Address Mg marg baluahi district : khagaria state : bihar
 Pin Code 851204
State of Domicile Yes
Home District KHAGARIA

Educational Qualification
  Board/University Institute Type State Specialization Passing Year Marks Obtained
 (%)
I.Matric JAC BOARD Gevernment Jharkhand 2012 62.4
II.Intermediate JAC BOARD Gevernment Jharkhand Arts 2014 57
III.Degree VBU HAZARIBAG Gevernment Jharkhand Sociology 2017 51.4
IV.Post Graduation Private 0 0

Experience
Designation Date of Joining Reason for Resign Salary Job Status
COUNSELLOR 01-Jul-2017 BECAUSE OF HEALTH ISSUE 10000 Permanent

Points
Total Point   61.93

I declare that all the above information is correct to the best of my knowledge and that I shall be liable for punishment if information
is found incorrect. I also declare that I have understood the guideline for engagement and will fully abide by the same including any
further guideline issued by ICDS, Government of Bihar in this regard. I categorically declare that there is no pending Criminal case or
serious complaint against myself.

Place:-

Date:-
Signature of Applicant