APPLICATION FORM
Applied for the post_______________________ Photo
Location (Raipur/Durg/Bilaspur/New Raipur) ___________________
1. Service No. :
2. Rank on Retirement :
3. Name :
4. Age :
5. Date of retirement :
6. Total Service :
7. Educational qualification
(a) Academic :
(b) Computer Literacy :
8. Experience
(a) Working in CSD Canteen :
(b) Office work :
(c) Software Opering :
(d) Internet Knowledge :
9. Address
(a) Present :
(b) Permanent :
10. Contact No. :
11. Email :
Note : Bring all related documents during interview
DECLARATION
I hereby declare that the above information is true to the best of my knowledge and belief.
Date: (signature)
HQ COSA, Raipur
Opp Suyash Hospital
Gudhyari Road Kota
Raipur Chhattisgarh 492010
E Mail : hqcosaurc1985@gmail.com