Block Coordinator Application

Email:
contactus@gmbvsstrust.org

APPLICATION FORM FOR BLOCK COORDINATOR

Gramin Mahila Aaur Bal Vikash Sewa Sangh Trust

Mob:
+91 8235881010

1. Name of the Applicant *

2. Father's / Mother's Name *

3. Gender *

Male Female

4. Mobile Number *

5. Email *

6. Date of Birth *

Date of Birth

Age (Auto-Calculated)

Passport Size
Photo Enclosed
(3.5cm × 4.5cm)

(Max 20KB)
(Click to Upload)

Signature
(Max 20KB)

ADDRESS & QUALIFICATION DETAILS

7. State *

8. District *

9. City / Village *

10. Panchayat *

11. Block *

12. Ward *

13. Full Address *

14. For Which Block Applying For *

15. Highest Qualification *

Graduation Post Graduation Other

16. Category *

General OBC SC / ST

17. ID Type *

18. ID Number *

ATTACH REQUIRED DOCUMENTS

19. 10th Marksheet

10th Marksheet (Only PDF, Max 150KB)

20. 12th Marksheet

12th Marksheet (Only PDF, Max 150KB)

21. Graduation Marksheet

Graduation Marksheet (Only PDF, Max 150KB)

22. Identity Proof (Aadhaar/Voter ID/Passport/DL)

ID Proof (Only PDF, Max 150KB)

23. Income Certificate

Income Certificate (Only PDF, Max 150KB)

24. Caste Certificate

Caste Certificate (Only PDF, Max 150KB)

25. Residence Certificate

Residence Certificate (Only PDF, Max 150KB)

26. PAN Card

PAN Card (Only PDF, Max 150KB)

Declaration: I hereby declare that the information and documents provided above are true and correct to the best of my knowledge. I understand that if any information is found to be false, my application will be rejected. I agree to abide by the terms and conditions laid down by GMBVSS Trust for the Block Coordinator position. I understand that selection will be based on Merit & Personal Interview.

Signature will appear here

Signature of Applicant

Application Form

APPLICATION FORM FOR BLOCK COORDINATOR