Application form

Nilachal Seva Pratisthan
AT-Benagaon(Dayavihar), P.O-Gadasahi,P.S-Kanas, Dist-Puri, Odisha-752017 ,Email-nspodisha@gmail.com

Application Form

Application for the post -

Click here to retrieve your old/incomplete application.

Select Application for the post - Select the Post

*Registration Number

*Applicant Name(in Block letter)

Enter Name

*Gender

Male

Female

Select Gender

*Marital Status

Unmarried

Married

Select Marital Status

*DOB

Enter DOB

*Email

Enter valid Email

*Mobile No.

Enter valid Mobile No.

*Father's Name

Enter Father Name

*Mother's Name

Enter Mother Name

*Present Address

*Permanent Address

Enter Permanent Address

Affix Photograph(size: max 200 KB)

Choose Your Affix Photograph

Signature(size: max 200 KB)

Choose Your Signature

Secondary Matriculation :-

Name of the Qualification Awarded

Board/University

Subject specialisation

Year of Passing

Passing Category

Percentile /Percentage /OGPA / GRADE

Photocopies of Certificates(size: max 200 KB)

Higher Secondary(10+2):-

Name of the Qualification Awarded

Board/University

Subject specialisation

Year of Passing

Passing Category

Percentile /Percentage /OGPA / GRADE

Photocopies of Certificates(size: max 200 KB)

Graduation:-

Name of the Qualification Awarded

Board/University

Subject specialisation

Year of Passing

Passing Category

Percentile /Percentage /OGPA / GRADE

Photocopies of Certificates(size: max 200 KB)

Post-Graduation:-

Name of the Qualification Awarded

Board/University

Subject specialisation

Year of Passing

Passing Category

Percentile /Percentage /OGPA / GRADE

Photocopies of Certificates(size: max 200 KB)

Others:-

Name of the Qualification Awarded

Board/University

Subject specialisation

Year of Passing

Passing Category

Percentile /Percentage /OGPA / GRADE

Photocopies of Certificates(size: max 200 KB)

Employment Details :-

Name of the Organisation

Designation

Period

Key responcibility Handled

Self_Attested Photocopies of Experiences(size: max 200 KB)

Computer Literacy:-

Pacage/Application

Details of Exposure/Proficiency

Language Proficiency:-

Sl #	Language	Ability to Converse	Ability to Read	Ability to Write
1	English
2	Odiya
3	Hindi

References (2):-

Name

Address

Organisation

Designation

Mobile

Your Professional relationship with

Name

Address

Organisation

Designation

Mobile

Your Professional relationship with

Please keep this Registration number for future corresponds. Incase for any reason you loose data, you can easily retrieve it from above given link using Registration number and Mobile

9438018582

nspodisha@gmail.com

Application Form

Secondary Matriculation :-

Higher Secondary(10+2):-

Graduation:-

Post-Graduation:-

Others:-

Employment Details :-

Computer Literacy:-

Language Proficiency:-

References (2):-