ARC360 Register Now for ARC360 For College Use Only Application No Roll No Class Semester Roll # Candidate's Name 1. Father's Name 2. Occupation 3. Postal Address 4. Email 5. Domicile 6. Marital Status SingleMarried 7. Gender MaleFemale 8. National Identity Card No 9. Religion 10. Date of Birth Academic Record Matric/S.S.C 1. Institution 2. Subjects 3. Marks Obtained 4. Total Marks Intermidiate 1. Institution 2. Subjects 3. Marks Obtained 4. Total Marks Graduation 1. Institution 2. Subjects 3. Marks Obtained 4. Total Marks Masters 1. Institution 2. Subjects 3. Marks Obtained 4. Total Marks Name: Class: Semester: College Roll#: Test Roll#: University Coordinator Signature & Stamp 12. Please (✓) Tick 'Yes' or 'No' against the certificate and other documents which you have attached with this application. National Identity Card YesNo Matriculation YesNo Intermediate YesNo Graduation YesNo B.Ed. YesNo LL.B/LL.M YesNo MA/MSC/M.Ed YesNo M.Phil./Ph.D/Equivalent YesNo F.C.P.S/Equivalent YesNo Research Paper(s) YesNo One Attested Photograph YesNo Domicile Certificate YesNo Experience/Service Certificate(s) YesNo In Case of Govt Service, Departmental Permission Certificate YesNo In case of Disabled Person, Registration and Medical Certificates YesNo If applying on the basis of equivalent qualification, Certificate of equivalence YesNo Certificate of equivalence In case of Overage/Underage, Age Relaxtion Order (in orignal) YesNo If last service was terminated for want of vacancy, Certificate of such service In case of Ex-Serviceman YesNo Discharge Certificate Certificate of Registeration with PMDC/PEC/PCAT/PBC Medical Certificate of Physical standerd YesNo if prescribed Certificate of Practice as Lawyer YesNo if prescribed Certificate of service as Barrister/Advocate/Member of establishment of Courts YesNo Affidavit declaring actively participating in the Profession of Law (if prescribed) YesNo 13. I DO HEREBY SOLEMNLY DECLARE THAT THE REPLIES GIVEN BY ME IN THIS APPLICATION FORM ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF, I FULLY UNDERSTAND THAT THE FACTS GIVEN ABOVE WILL SERVE AS THE BASIS FOR DETERMINATION OF MY ELIGBILITY BY THE COMMISION AND MY CANDIDATURE SO DETERMINED BY THE COMMISSION WILL STAND PROVISIONAL UNTILL, IT IS VERIFIED WITH THE ORIGINAL, CERTIFICATES AT THE TIME OF INTERVIEW I WILL NOT CLAIM BENEFIT OF ANY INFORMATION WHICH IS NOT MENTIONED IN THE APPLICATION FORM AND IS PRODUCED AFTER THE CLOSING DATE FOR SUBMISSION OF APPLICATIONS 14. I ALSO UNDERSTAND THAT IF AFTER THE CLOSING DATE FOR SUBMISSION OF APPLICATIONS MY APPUCATION IS FOUND INCOMPLETE. WRONGLY FILLED IN UNSIGNED OR NOT ACCOMPANIED BY TREASURY RECEPT/BANK CHALLAN IN ORIGINAL AND ATTESTED COPIES OF OTHER REQUESTIE DOCUMENTS, IT WILL BE LAIABLE TO REJECTION, AND THAT IF ANY FACT IS CONCEALED OR MIS-STATED IN THE ABOVE REPLIES. DISCIPLINARY ACTION SHALL BE TAKEN UNDER THE RULES. 15.I ALSO UNDERSTAND THAT MY RECOMMENDATION FOR SELECTION COULD BE WITHDRAWN BY THE COMMISSION AT ANY STAGE IN MY SERVICE I AM FOUND INELIGIBLE FOR THIS POST. Date CANDIDATE SIGNATURE Δ
