Railway Recruitment Cell application form

Railway Recruitment Cell APPLICATION FORM Emp. Notice : 220E/Open Mkt/RRC/2013
Northern Railway

Control No.
Lajpat Nagar-I, New Delhi 110 024

1. 
   
   Name-
   
   
   Address-
   
   

   Paste your recent Photograph ( 3.5 cm X 2.5 cm )

   
   

   Without Cap/Skull Cap/Muffler & Goggles

   
   Correspondence
   

Address of applicant :

( in CAPITAL)


( Use Black Ball Pen only )





STATE-

PIN-

Nearest Rly.Station-

NOT IN CAPITAL

Applicant’s Signature

2. 
   Applicant’s Name :
   

( in CAPITAL )

3. 
   Father’s/Husband’s Name: (in CAPITAL)
   

4. 
   Permanent Body Mark of Identification :
   

5. 
   Phone with STD Code/Mobile no:
   

SCRIBE
DD MM Y Y Y Y YY MM DD OH-1 HH-2 VH-3 % Required?

6. 
   
   
   
   
   
   
   Date of Age as on 7. Physically
   

Birth : 01-01-14 Handicapped:

Hindu 1

Muslim 2

Christian 3

Sikh 4

Budhist 5

Jain 6

Parsi 7

Other 8

8. Sex : (M-1) (F-2) 9. Religion:
Y / N

UR 1

OBC 2

SC 3

ST 4

10.Commu- nity:

12. 
    

    10th	12th	ITI	Grad
    1	2	3	4

    
    
    
    Qualification :
    

12. 
    Documents Enclosed :
    

11.Relax-

ation On:

OBC-1 SC-2 ST-3 ITI-4 PH-5 (OH/HH/VH)
J&K-6 Separated/Divorced Women-7 Other-8

Passing Month/Year Percentage MM YY % (2+2)

12. 
    

    1.	3.	5.
    2.	4.	6.

    
    
    
    Fees details :
    

Bank Receipt No/IPO detail Date Amount Details of Bank /Post office

12. 
    Declaration : I, hereby declare that all statement in application are true and correct to the best of my knowledge and belief. In the event of information being found False or Incorrect my candidature / appointment may be cancelled without any notice.
    

(Please copy above declaration in your own running handwriting) (NOT IN CAPITAL)





Left Thumb Impression of Applicant Applicant’s Signature
Date : (in English)-
Place: ( in Hindi ) -