ONLINE APPLICATION UNDER MHRB, ASSAM
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Post Applied for
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Name of Applicant
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Date of Birth (As per Matriculation Cerftificate)
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Gender
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Nationality
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Caste
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General
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ST (H)
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Mobile No
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E-Mail ID
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Father's Name
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Are you a Person with Disability (PWD) ?
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Yes
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Please indicate under which category of reservation you have applied for
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Economically Weaker Section(EWS)
OBC/MOBC
SC
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Orthopaedically Handicapped
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Correspondence Address
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C/O:
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House No.:
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Vill/Town:
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Post Office:
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Police Station:
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District:
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Baksa
Barpeta
Bongaigaon
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Goalpara
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Hailakandi
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PIN:
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State
Permanent Address
Same As Correspondence Address
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C/O:
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House No.:
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Vill/Town:
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Post Office:
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Police Station:
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District:
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Baksa
Barpeta
Bongaigaon
Cachar
Chirang
Darrang
Dhemaji
Dhubri
Dibrugarh
Dima Hasao
Goalpara
Golaghat
Hailakandi
Jorhat
Kamrup Metro
Kamrup Rural
Karbi Anglong
Karimganj
Kokrajhar
Lakhimpur
Morigaon
Nagaon
Nalbari
Sivasagar
Sonitpur
Tinsukia
Udalguri
Outside State
Biswanath
Charaideo
Hojai
Majuli
South Salmara
West Karbi Anglong
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Enter District Name:
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PIN:
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State
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Essential Qualification (As per advertisement)
Qualification
Name of Course
Course Duration in year
Course start date
Course end date
Institute Name
University Name
Mode of Course
Subjects
Year of passing
% of Marks obtained
Division/ Class /Grade
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Full Time
Correspondence
Distance
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1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
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1982
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2004
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2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Qualification Details
Exam Passed
Name of Degree
Subject
Stream
Institution Name
University Name
Course Duration in year
Year of passing
% of Marks
Division/ Class /Grade
Full Time/ Correspondence/ Distance
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10
Select
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
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1987
1988
1989
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1991
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1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Select
Full Time
Correspondence
Distance
10+2
Select
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Select
Full Time
Correspondence
Distance
Degree
Select
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Select
Full Time
Correspondence
Distance
PG
Select
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Select
Full Time
Correspondence
Distance
Professional Qualification
Select
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Select
Full Time
Correspondence
Distance
Other Qualification
Select
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Select
Full Time
Correspondence
Distance
Registration No.
Registration under
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State Council/ Board
Central Council/ Board
Other
Registration No.
Experience Details
Name of Organization
Designation
Nature of duty
From Date
To Date
Year of Service (YY/MM)
Total Experience in months
Fee
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Treasury Challan No & date
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Declaration
I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found untrue or incorrect at any stage of my not satisfying any of the eligibility criteria stipulated, my candidature is liable to be cancelled.