(For Office Use) NO:
Passport size
photo
(to be self attested)
TAMIL NADU AGRICULTURAL UNIVERSITY
APPLICATION FOR THE POST OF
Assistant Agricultural Officer
Ref. No. R1/5838/2017 dt.
1.
Name in full (in Block letters)
:
2.
Father's / Husband's Name
:
3.
Date of Birth *
:
4.
Gender
[Male / Female / Trans Gender]
:
5.
Place of Birth and Nativity
(District and State) *
:
6.
Marital status
:
7.
Whether belongs to Hindu / Christian :
/ Muslim
8.
Community to which belongs
OC / BC / MBC / SC / ST *
(indicate caste specifically)
:
9.
State priority category if any
:
(Differently Abled Persons / Destitute
Widow / Ex-servicemen etc.,) *
10. Present address for communication
:
with e-mail ID., Mobile no., Landline
no:
11. Permanent Address
:
12. Employment Registration No. /
Ex-Servicemen Registration No.
:
* Copies of Proof should be enclosed
22.06.2017
8. Educational qualification (Copies of proof should be enclosed)
Course Studied
Duration
Year of
Institution Studied
passing
i.
Class or Grade
ii.
iii.
9. Experience regarding previous and present employment (Copies of proof should be
enclosed)
S.No.
Post held
Office
From
To
Total Service
Y
M
D
Total
10. Centre of preference
Name of the Examination centres
Agricultural College and Research Institutes viz., Coimbatore
/ Madurai / Trichy / Killikulam / Vazhavachanur and
Horticultural College and Research Institute, Periyakulam.
:
11. Bank draft details (Original DD should be attached)
Demand draft No. & Date
Amount (Rs.)
Name of the Bank
(any nationalized bank)
I certify that the information furnished above are true and correct to the best of my
knowledge and belief. Should there be any incorrect or false information having been furnished or
that may come to light in due course, I bind myself for such action as the University may decide.
Place:
Date:
Signature of the applicant
List of enclosures (Attested copies)
1.
2.
3.
4.
5.
6.
7.
8.
Self attested photo graph affixed and signed
Copies of academic certificates
Experience certificate
Copy of Community Certificate
Proof of Date of Birth
Certificate for having studied in Tamil Medium
Proof for Differently Abled Persons / Destitute Widow / Ex-servicemen
Proof for Technical Qualification if any