CENTRE FOR RAILWAY INFORMATION SYSTEM - Indian Railways

CENTRE FOR RAILWAY INFORMATION SYSTEM
APPLICATION FORM FOR RECRUITMENT TO THE POST
OF ENTRY LEVEL ENGINEERS / SENIOR LEVEL ENGINEERS
(STRIKE OFF WHICHEVER IS NOT APPLICABLE)
Post Box No. 2282
Chankayapuri, New Delhi 110021
PASTE HERE
YOUR RECENT
PASSPORT SIZE
PHOTOGRAPH
AND SIGN IT
ACROSS
With reference to your advertisement in the ________________ , I submit my application in the prescribed
format for the post* of Entry level Engineers (Assistant Software Engineers) / Senior Level Engineers
(Software Engineers/Sr. Software Engineers).
(*Clearly indicate the post applied for.)
One more photograph
may be enclosed.
1. FULL NAME IN BLOCK LETTERS: Mr./Ms._______________________________________
(As it appears on your educational certificates)
2. FATHER’S/HUSBAND’S NAME: _________________________________________________
3 ADDRESS FOR CORRESPONDENCE: ____________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
__________________________________________________Pin- ____________________
4 PERMANENT ADDRESS: ________________________________________________
_______________________________________________________________________
________________________________________________________________________
______________________________________Pin- ________________________
Tel. No.(with STD Code) _______________________ E-Mail ___________________________

5. CENTRE OF WRITTEN EXAMINATION___________________________________________
(Delhi, Mumbai, Kolkata and Chennai - Choice of centre in order of preference may be given by those
applying for the post of Entry Level Engineers)
6 CATEGORY _________________________________________
In case of SC/ST/OBC candidate, please enclose attested photocopy of certificates
7 DATE OF BIRTH _____________________ Age : ___________________
(Please enclose attested photocopy of certificate)
8 GENDER Male Female (mark “√” in appropriate place)
9 NATIONALITY _______________________________________
10 EDUCATIONAL & PROFESSIONAL QUALIFICATIONS: MATRICULATION/SSLC
ONWARDS (please enclose attested photocopy of certificates)
Examination Passed/
appeared/appearing
Name of the
Institution/
University
Subjects studied in
detail
Date, Month & Year
of Passing
Percentage of
marks/Grade
11 PARTICULARS OF WORK EXPERIENCE, IF ANY (Post qualification experience only may be given
– this is essentially required for those applying for the post of Senior Level Engineers)
Name of the
Designation
Period
Areas of experience
employer(s)
From
To
(Attested Photocopy of experience certificate may be enclosed)

I hereby declare that all statements made in this application are true, complete &
correct to the best of my knowledge and belief. I understand that in the event of any
information being found false or incorrect at any stage or not satisfying the eligibility
criteria according to the requirements of the relative advertisement, my
candidature/appointment is liable to be cancelled/terminated.
Place : __________
Date : __________
SIGNATURE OF CANDIDATE