Complete Application Form
West Bengal Essential Commodities Supply Corporation Ltd.
11A,Mirza Ghalid Street, Kolkata - 700087
Registration  No : Advertisement No:ESTT/50/2011(Pt1)/MD/1514
Post Applied For : Serial No. of post :
Applicant's Personal Details:  
Applicant's Name:   Applicant's Photo
Father’s/Husband’s Name:
Gender: Religion:
Marital Status Nationality:
Date Of Birth: Age as on 01.01.2013 :
Community/Category :
Designation of issuing authority of S.C./S.T./O.B.C. Certificate:  
Sub-Caste(for S.C./S.T./O.B.C. candidate):  
Are you a person with disabilities (having physical disability of 40%):
If yes, Choose type of disabilities:  
Do you belong to (Exempted Category/Meritorious Sports Person/Ex-serviceman)?  
If yes, put tick mark Exempted Category 
Are you in service in Govt./PSU/Govt. statutory bodies (State Yes or No) 
Language(s) known :
Spoken Written Mother Tongue
Academic Qualification : (Fill details of Qualification pertaining to you, which makes you eligible)
Name of Examinations passed/Course Completed Name of Board/ Council/ University/ Institute Division/ Class Year of Passing % of Marks obtained Subject(s) taken/ details of course
Experience for the Post applied for, if applicable:
Other Employment Details, if any:
Name of post Institution/Office where employed Permanent or temporary Date of joining (exact date) Date of leaving (exact date) Cause leaving Gross Pay
Other Details:
Any other relevant information with reference to the requirement of the post:
Applicant's Communication Details:
Permanent Address:
Address Line1:
Address Line2:
Post Office: , Police Station:
Town/City: , State:
District: , PIN:
Communication Address:
Address Line1:
Address Line2:
Post Office: , Police Station:
Town/City: , State:
District: , PIN:
Contact Details: Mobile No: 91 Email ID:
Pay Details:
Amount : Journal Number : Date of Deposit :

I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief and in the event of any information being found false at any stage my candidature is liable to be cancelled.

(Applicant's Signature)