O/o the District Magistrate Paschim Medinipur
Government of West Bengal, Paschim Medinipur
** Online Application Form **
Personal Information
Mobile No
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Applicant Name
*
Father/Husband Name
Date of Birth
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Address
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Age as on 01/01/2024
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District
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Select
Paschim Medinipur
Alipurduar
Bankura
Birbhum
Cooch Behar
Dakshin Dinajpur
Darjeeling
Hooghly
Howrah
Jalpaiguri
Jhargram
Kalimpong
Kolkata
Malda
Murshidabad
Nadia
North 24 Parganas
Paschim Bardhaman
Purba Bardhaman
Purba Medinipur
Purulia
South 24 Parganas
Uttar Dinajpur
Sub Divison
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Select
Block/Municipality
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Select
Pin
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Email ID
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Nationality
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INDIAN
Sex
*
Select
Male
Female
Other
Category
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GEN
SC
ST
OBC-A
OBC-B
Applied for the Department
*
Select
Women & Child Develipment and Social Welfare Department
DISTRICT CHILD PROTECTION UNIT
SPECIAL JUVENILE POLICE UNIT
Applied for the Post
*
Select
Typing Speed (in WPM)
Educational Qualification
10th STD
Board Name
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Year of Passing
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% of Marks obtained
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12th STD
Board Name
Stream
Select
ARTS
SCIENCE
COMMERCE
Year of Passing
% of Marks obtained
Gradutation
Unversity Name
Stream
Select
BA
BCOM
BSC
BCA
OTHER
Honours
No
Yes
Year of Passing
% of Marks obtained
Post Gradutation
University Name
Stream
Select
MA
MCOM
MSC
MCA
OTHER
Year of Passing
% of Marks obtained
Other
Qualification
Year of Passing
% of Marks obtained
Computer Knowledge
Course Name
Institution Name
Year of Passing
Grade
Working Experiences
Organisation Name
Designation
Experiences in Year
Additional Experience (if any)
Photograph & Signature Information
Applicant Photo
*
Applicant Signature
*
* Max Photo Size: 50KB & Format: jpg or png
Declarations
*
I do hereby declare that above stated information is true to the best of my knowledge and belief and my candidature is likely to be cancelled if any of the particulars are found to be incorrect.