* Indicates Compulsory fields..

Application Form

Personal Details

*Post Applied

*Surname & Name:

(30 Chars) As per SSC / 10th Memo

*Father's Name:

(30 Chars)

*Identity Card Type:

*Identity Card Number:

(20 Chars)

*Gender:

Male

Female

* SSC/Equivalent

Regular

Private

All the Candidates (Including SC,ST & OBC candidates) belonging to any state other than Telangana State will be considered only against OC vacancies.

Basic Data

*Local/Non-Local:

Local

Non-Local

(SSC Regular Candidates Need Not Click This -Local Status Will Be Calculated By System)

*Native State:

*Native District :

*Caste:

*Is SCCL Employee:

Self Employee Code:

External candidates no need to enter employee code

*Is Your Parent/Relative
An SCCL Employee ?

Parent/Relative Employee Code:

*Date of Birth:

Ex:(dd-MM-yyyy) Age As on 12-Sep-2024

*Please Enter Given Captcha:

473584

Address for Communication

*HNo:

(30 Chars)

*Street:

(30 Chars)

*Village/Town/City:

(30 Chars)

*District:

(30 Chars)

*State:

*Pin Code:

(ex:507101)

*Enter Your valid Mobile No.

Ex: 9478028019 (10 digits)

*Re-enter Mobile No.

(10 digits)

*Email Id:

ex:- hari@yahoo.com (max Chars 40)

Qualifications

Examination Passed	Prescribed Qualification	Subject	Name And Place of University/Board(20 Chars)	Percentage of Marks 00.00	Pass Year #
Qualification	* Required	* Required	* Required	* Required *Pl.See Marks %	* Required

Post Qualification Experience Details

Experience Details	From Date (in dd-mm-yyyy format)	To Date (in dd-mm-yyyy format)
Experience1	*To Date Less Than From date	*From Date Greater Than To date
Experience2	*To Date Less Than From date	*From Date Greater Than To date
Experience3	*To Date Less Than From date	*From Date Greater Than To date
Experience4	*To Date Less Than From date	*From Date Greater Than To date
Experience5	*To Date Less Than From date	*From Date Greater Than To date
Total Experience (Click Calculate To Calculate Experience From BreakUp)

Other Information

If employed, working in:

Indian Medical Council Reg.No(MBBS):

Indian Medical Council Reg.No(PG/DNB/DIPLOMA):

*Identification Mark-1(As Per SSC):

Identification Mark-2 :

Uploading Of Photo With Signature And Certificate(s)

*Upload Photo with Signature:

(10-50 KB)

Sample Image

*Place:

Declaration, Confirmation & Data Submit

I declare that I have ensured my eligibility for the post applied against Notification No.03/2024 and all the information furnished above is true/correct to best of my knowledge and records, I understand that if any information submitted by me is proved to be false at any stage, the decision of the Management will be final and binding on me including cancellation of my candidature and also I am liable for criminal prosecution. Further, I agree to abide by the rules, and regulations and the details mentioned in the Notification No.03/2024 kept in SCCL website.

Verified all the above furnished Data