PROFESSIONAL AND EXECUTIVE EMPLOYMENT OFFICE 56,SANTHOME HIGH ROAD, CHENNAI-4 REGISTRATION FORM(X-1) RELIGION CASTE ADDRESS FOR COMMUNICATION EDUCATIONAL QUALIFICATION DEGREE/PG DIPLOMA SUBJECT CLASS & MEDIUM YR PASS REGISTRATION NUMBER PE. /WPE./ REGN.DATE ..... 2004 NCO NO. S.F. DATE PRIORITY IF ANY 1. 2. 3. 4. OTHER DETAILS IF ANY PRIORITY/EXPERIENCE/SPORTS ...... FOR OFFICE USE ONLY ASSISTANT DIRECTOR. INSTRUCTIONS FOR FILLING UP THE THE REGISTRATION FORM (X-1) 1. Use Captital Letters only for filling up the X-1. 2. Write the Name as in your Degree Certificate. 3. Mention the Communuity and Sub-Caste. 4. Cleary indicate the TALUK, DISTRICT AND PINCODE. 5. Specify only PROFESSIONAL/P G DEGREE/P.G.DIPLOMA. 6. Residents of Chennai should mention the Graduate Teacher Qualifications. 7. Indicate the Priority category such as Destitute Widow/Intercaste Married Couple/Dependent of Serving Personnel/Ex.Servicemen/LandAcquisition/Legal-heir of Freedom Fighter/Tamil servants/Physically Handicapped/Orphans/Burma-Srilanka Repatriates/Census, etc., Copy of the certificates obtained from the concerned authority should be enclosed. 8. Previous working experience if any may be indicated after obtaining proper Experience Certificate from the concerned employer. Enclose Attested Xerox copy of Provisional Certificate, Community Certificate, SSLC certificates (Proof for date of birth) and ration card.
