STANDARD FORM OF APPLICATION
(ASSAM GAZETTE OF PART-IX)

(For Candidates apply for the posts of Driver)

Your Online Reference Number REF/2017/12/15/054000
[Please note this number for furture reference.]
Desired Post *
    
Name of Candidate *
Gender *
   
Passport Size Photograph *
Present Address *
Permanent Address *
Father Name *
Place of Birth *
Police Station *
Cell Phone No/ Contact No (if any)
Email (if any)
District *
Citizen of India *
   
Educational Qualification *
Name of Last Educational Institute *
Address of Last Educational Institute *
Other Qualification
Community *
Religion *
Cast *
Date of Birth *  Pick a date
Present Occupation *
Previous Appointment If Any
Are you a trained in or a member of the
National Cadet Crops of Territorial Army
or Trained Home Guards and Civil Defence Volunteers *
if so give particulars
Employment Registration No *
Whether There Is Any Govt Employees In Your Family *
Examination Centre *
  1. Eastern Zone at Jorhat (covering areas of Jorhat, Sivasagar, Dibrugarh and Tinsukia district.)
  2. Western Zone at Bongaigaon (covering areas of Bongaigaon, Dhubri, Goalpara district)
  3. Northern Zone at Tezpur (covering areas of Sonitpur, Darrang, Lakhimpur, Dhemaji district)
  4. Southern Zone at Silchar (covering areas of N.C. Hills, Cachar, Karimganj, Hailakandi district)
  5. Central Zone at Nagaon (covering areas of Karbi- Anglong, Nagaon, Golaghat and Morigaon district)
  6. Central Western Zone, Guwahati at. R.T.C., Sila, North Guwahati-31 (covering areas of Kamrup(M),Kamrup (R), Barpeta and Nalbari district)
  7. B.T.A.D. Zone at Kokrajhar (covering areas of Kokrajhar, Baksa, Chirang and Udalguri district)
Date *  Pick a date
Place *
Status *

The fact stated above are true to the best of my knowledge and belief. In case of my false statements, I am liable to any action the Government may fit and proper