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Kerala Science Job Application Form

This document contains an application form for a post at the Kerala State Council for Science, Technology & Environment. The application requests information such as the applicant's name, date of birth, address, contact details, educational and professional qualifications including work experience, referees, and a declaration signed and dated by the applicant. Upon submission, the form and attachments would be reviewed for consideration for contractual employment.

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Adhithya Kiran
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50 views2 pages

Kerala Science Job Application Form

This document contains an application form for a post at the Kerala State Council for Science, Technology & Environment. The application requests information such as the applicant's name, date of birth, address, contact details, educational and professional qualifications including work experience, referees, and a declaration signed and dated by the applicant. Upon submission, the form and attachments would be reviewed for consideration for contractual employment.

Uploaded by

Adhithya Kiran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

Kerala State Council for Science, Technology &

Environment
Sasthra Bhavan, Pattom P.O, Thiruvananthapuram – 695 004

Application Form
Paste a recent
Colour Passport
size Photograph
1 Name of the Post

2 Name

3 Father’s Name

4 Nationality

5 Date of Birth

6 Age as on 01.01.2019

7 Address for Communication

8 Permanent Address

9 Tel No., Mob No. & E-mail Id

10 Educational Qualification ( Attach self attested copy)

Examination/ Board/University Subject Year of Class/Div %


Degree Passing Marks
11 Additional Qualifications ( if any) (Attach self attested copy)

12 Certification Course in IPR (if any) (Attach self attested copy)

13 Details of Work Experience (Attach self attested copies)

Period Name & Address of Designation Nature of Duties


the Organization
From To
(DD/MM/YY) (DD/MM/YY)

14 Name, Address & Contact Details of 2 Referees:

15 List of Enclosures :

DECLARATION:

I understand that the appointment is contractual and I hereby declare that the
information given above is correct, true to facts and nothing has been concealed /
distorted. I am aware that, if at any time I am found to have concealed/distorted
any material information, my candidature/engagement is liable to be summarily
terminated without notice.

Date:

Place: (Signature of the Candidate)

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