Bio data

1. Fix a Recent
Time Passport
size Photo
Placement Advisory Bureau ITI KESHOD

Bio-data Form

Registration No :………………….

1. Name..................................................................................
2. Father's Name....................................................................
3. Present address with tel. no..............................................
............................................................................................
4. Permanent address with tel. no..........................................
............................................................................................
5. Nationality................................ 6. Domicile state.........................
7. Date of birth............................. 8 Age.........................................
9. Gender (M
□ / F □ ) 10. Marital Status (Married □ / Unmarried □ ) If married no of kids....)
11. e mail ID.......................................12. Mobile no......................................

13. Academic qualification:-
Year of passing Institute Board Marks obtained Stat us
10th
12th
ITI
Others

14. Family records:-
Occupation
Father Mother Brother Sister
Husband/Wife
(if married)

Monthly income
Property
(Land/House)

15. Religion.............. 16. Caste GC □ OBC □ SC □ ST □
17. Language known.........................................................................................................
18. Any physical difficulties? Yes/No ............ if yes, brief.................................................
19. Blood group............................. Height........................... Weight..............................
20 Any police /legal case against you or any of your family members? (Yes/No).........if yes, details.......
To the best of my knowledge, the information give n above is correct and I would like to apply
for the requirement process. If above details are found to be incorrect, I am liable for termination from
employment any time without any notice.
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