APPLICATION FORM 1. Rank/ Name of official : 2. Unit / PID No. : 3. Present Place of posting: 4. Parent Zone : 5. Fathers Name : 6. a) Permanent Address: i) Village ii) Mohalla iii) Tehsil : _____________________________ iv) District : _____________________________ Tel. No.______________ Mobile No. _____________ b) Present address for correspondence: ____________________________________________ 7. Date of birth (in Christian Era) : _____________________________________ 8. Date of appointment in Police Deptt:_____________________________________ 9. Date of promotion, if any :______________________________________ 10. Training Course undergone : ______________________________________ 11. Educational Qualification : ______________________________________ 12. Technical Qualification : _______________________________________ 13. I hereby solemnly declare that the above particulars are correct to the best of my knowledge and belief. In case of any of the above averments is found to be incorrect, I shall be liable for disqualification for conversion as ASI(S). Signature of the Applicant. Countersigned by Head of Office FOR INSERVICE CANDIDATES FOR CONVERSION AS ASI(S) YEAR 2009 *** _________________________________ :______________________________ :______________________________ Space for photograph to be attested by concerned Head of the Unit
