Self-Declaration

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Presently, I am not involved with any Child Care institution (CCI) - Children Home /Adoption. Agency / Open Shelter unde
Self-Declaration

I Shri / Smti. --------------------------------------------------------- Son of------------------------------------------------- Vill/ town ------------------------- --------------------------------------------P.O. ------------------------------------------- P.S. -------------------------------------- Dist.------------------------------- Mouza------------------------------------------ PIN -------------- would like to apply for the post of Member /Social Worker (CWC / JJB) / as per the advertisement (clause no. V. a to e) hereby declared that a. I am not convicted under any law. b. I have not violated any child rights or employed any child labour or any other human rights or immoral act. c. I am not holding such other full time occupation which does not allow me to give necessary time and attention to the work of the board / committee; d. I have complied with all the qualification and experience prescribed in the Act and rules e. Presently, I am not involved with any Child Care institution (CCI) - Children Home /Adoption Agency / Open Shelter under JJ Act.

Signature of the Candidate