Department of Food
Department of Food
PUNJAB
APPLICATIONFOR THE POST OF……………………………………………….....
1. (a) Category
GEN SC/ST:OTHERS MAJ/BALMIKI BC
4. Have you done 120 Hrs. Computer Courses as per notice Yes No
9.Age on 31.01.2011
Years Months Days
11.Candidate’s Name (in Capital letter)Please leave one box blank between first, middle & surname)
Name : ____________________________________
Father’s/Husband Name _______________________
Address ___________________________________
___________________________________
City/Town:__________________________________
State:_______________________________________
Pin Code
15. Candidate’s Address(in Capital letters)
Name : ____________________________________
Father’s/Husband Name _______________________
Address ___________________________________
___________________________________
City/Town:__________________________________
State:_______________________________________
Pin Code
16.Nationality
18.If yes, do you have more than one living wife Yes No
20.Have you ever been dismissed from Govt. service of convicted by any Court Yes No
5 Bank Draft
I solemnly declare and affirm that the information given above is correct to the best of my knowledge
and belief.