8/14/2019 MCSCC Exam Form

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MANIPUR PUBLIC SERVICE COMMISSION

APPLICATION FORM

Manipur Civil Services Combined Competitive(Preliminary) Examination, 2008.

(Every column of this form is to be filled in by the candidates

own hand writing with ink or ball pen)

For office use only

SL. NO

1. Details of Fee Payable:-Rs.200/-(Gen & OBC) and Rs.50 (SC/ST) ( in cash only)

2. Full Name (IN CAPITAL LETTERS):-Dr/Ms/Mr.

..........

3. Fathers Name in full:....

4. Address:-(i)Permanent home address in full:--.

P.O. & P.S. ....

District .. State

(ii)Present postal address in full:- :--.

P.O. & P.S. ....

District .. StateD D M M Y Y

5. Date of birth:- (i)

(ii) In Words(...)

6. Age ( As on 1 st of July. 2008):- years . months . days(As per HSLC or Equivalent Examination)

7. Community:- (Gen/SC/ST/OBC)

If OBC : Meitei/Meetei or Meitei Pangal

(SC/ST/OBC candidates to furnish necessary documents in attested copies )

8. Optional Subject:-

(Indicate only one optional subjectfor this preliminary examination inCAPITAL LETTERS)

9. No. of previous appearance in the MCSCC Examination (Preliminary/ Main) by the candidate. :

10. Qualification(Degree onwards):-

11. Present occupation, if any:-12. Have you informed your employer/Controlling Authority

of your candidature in writing ?

DECLARATION

I hereby declare that all the statements made in this application are true and complete to the best of myknowledge and belief .In the event of any information being found false or incorrect before or after theexamination, action may be taken against me by the Commission as deemed fit.

Place: Signature of Candidate .

Date:

2(two)passport size

photos 1(one) tobe pasted and3(three) stampsize photos to

be attached