* Indicates Compulsory fields..

Online Application Form

Personal Details

*Post Applied

*Surname & Name:

(30 Chars) As per SSC / 10th Memo

*Gender:

Male

Female

*Father's Name:

(30 Chars)

*SSC/Equivalent

Regular

Private

I to VII class study details

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 :

*Category(SC/ST/BC):

*Date of Birth:

Ex:(dd-MM-yyyy) Age As on 12-Aug-2025

Address for Communication

*House No. /Flat No.:

(30 Chars)

*Street:

(30 Chars)

*Village/Town/City(PostOffice):

(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)

Enter Alternate Mobile No.

Ex: 9478028019 (10 digits)

*Email Id:

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

Educational Qualifications

Qualification Details	Examination Passed(100 Chars)	Subject(s)(100 Chars)	Name And Place of Institute (100 Chars)	Name And Place of University/Board(50 Chars)	Percentage of Marks(00.00)	Pass Year #
Necessary	* Required	* Required	* Required	* Required	Required % >= Required Only	* Required

Experience Details (Break-Up) Since Beginning of the Career In the Order Of Service(Ensure Total Years Of Relevant Experience Required)

Experience Details	From Date (in dd-mm-yyyy format)	To Date (in dd-mm-yyyy format)
Post Qual. Experience1	*To Date Less Than From date	*From Date Greater Than To date
Post Qual. Experience2	*To Date Less Than From date	*From Date Greater Than To date
Post Qual. Experience3	*To Date Less Than From date	*From Date Greater Than To date
Post Qual. Experience4	*To Date Less Than From date	*From Date Greater Than To date
Post Qual. 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 Presently Working in:

Name of the Organization (50 Chars.):

Photo With Signature

*Photo with Signature:

(10-50 KB)

Sample Image

*Place (20 Chars.):

Declaration, Confirmation & Data Submit

I declare that I have ensured my eligibility for the post applied against Notification No.03/2025 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.03/2025 kept in SCCL website.

Verified all the above furnished Data