Application Format - EQDC

ELECTRONICS AND QUALITY DEVELOPMENT CENTRE ( Under STQC Programme, DEITY, MCIT, Govt. of India) B-177/178,B-23/2 GIDC Electronics Estate, Sector 25, GANDHINAGAR – 382024, GUJARAT PH. 079-23287121/2/3/4, Fax- 23287121, Email : [email protected], Web:- www.eqdc.in

Application Form Affix here a recent Passport Size photograph

Post applied for: - _______________________________

1.

Name in Block letters

Mr./Ms. -----------------First

2.

Marital Status

------------------ ----------------Middle Last

Married/ Unmarried /Widows / Divorcee

a) Permanent Address :

……………………………………………………..... ………………………………………………………. ……. City ………. State.………. Pin Code………..

b) Postal Address :

……………………………………………………..... ………………………………………………………. ……. City ………. State..………. Pin Code………..

4.

Telephone and Mobile No.

1)…………………………2)………….……… 3)…………………………..

5.

E-mail Address

……………………………………………………..

6.

Date of Birth with documentary evidence

3.

National / Religion / Sex 7.

Present Age:

Year: _______ Months: ______

DOB: (DD/MM/YYYY) Date:………….. Month:….……….. Year………..

Nationality: Religion: Sex: Male / Female.

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Eqdc- Performa – appointment /2016-17 1/2

ELECTRONICS AND QUALITY DEVELOPMENT CENTRE ( Under STQC Programme, DEITY, MCIT, Govt. of India) B-177/178,B-23/2 GIDC Electronics Estate, Sector 25, GANDHINAGAR – 382024, GUJARAT PH. 079-23287121/2/3/4, Fax- 23287121, Email : [email protected], Web:- www.eqdc.in

8. Educational qualification - from starting to till date: (from Graduation onwards) (Original documents needs to be produced, if required) Sr. No.

Name of the degree /Certificate

Name of the Institution & Location

Name of the University

Passing Year

Percentage

9. Work Experience (from starting to till date) : Details required

Name of Employer/ Organization Name of Post Held Period of working Scale/ Total Emolument Work Assigned Kindly note- separate sheet for details can be attached

10. If selected what joining period would you require: 11. List of enclosures: *** I have submitted herewith attested copies of following documents serially: 1. 2. 3. 4. 5. 6.

Passport size Photograph (To be pasted on Application Format). School Leaving Certificate. True Copy of Mark Sheets (Graduation / Post Graduation). Degree Certificate. Experience Certificate Any Other Certificate

Declaration: I hereby declare that all statements made in this application are true and to the best of My knowledge and belief. In the event of any information being found false or incorrect or ineligibility being detected before or after the test and interview, my candidature will stand cancelled and all my claims of the Recruitment will stand forfeited.

Date: Place:

Signature of the Candidate

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Eqdc- Performa – appointment /2016-17 2/2