Rajasthan Skill and Livelihoods Development Corporation (A Government of Rajasthan Enterprise) J-8-A, EMI Campus, Jhalana Institutional Area, Jaipur 302004 Phone No. : 0141-5103248 (OPB), 2705817 Fax : 0141-5103246 Website: www.opbraj.org, E-Mail ID [email protected] (Registration Certificate B-476/ COM/RAJ /1000+/5/8814/2012 Issued by Ministry of Overseas Indian Affairs, New Delhi½ REGISTRATION FORM JOB TITLE : [ Education : Passport No. & Date : Experience : PHOTO Registration Fee Details : Rs. 1000/- by Demand draft No : Date : Drown in favor of “ Rajasthan Skill and Livelihoods Development Corporation Jaipur” (Non-refundable) I- PERSONAL PROFILE: 1- Name of the applicant in block letter as per passport / 2- a) Date of Birth / b) State 3- a) Father's Name in full b) Mother's Name in full 4- Address a) Office with Phone b) Residence (for communication) c) Pin Code - - - - - - 5- Contact Phone No. 6- e-Mail Address 7- Sex M- Male F - Female 8- Marital Status S-Single M- Married W- Widower/Widow 9- No. of Children II- EDUCATIONAL PROFILE 10- Qualification S. No. Qualification 1 2 3 4 5 6 7 8 9 10 5th/8th standard 10th standard 12th standard Graduate Post Graduate Diploma/I.T.I. Technical Non-Technical Para-Medical Other Certificate Course III- Name of Board/University Year of Passing Class/Grade Remarks WORK/SKILL PROFILE 11- Experience S. No. Name Employer Govt./Private Designation From To 1 2 3 4 12- a) Profession –Present: b) Sector G- Government P- Private O- Others 13- a) Passport No. b) Place of Issue d) Date of Issue e) Valid till 14.Key Experience (Not exceeding 50 words) / / / / __________________________________________________ __________________________________________________ __________________________________________________ 15. Foreign Driving License COUNTRY a) Heavy Vehicle b) Light Vehicle VALIDITY / / / / 16. Country/ Salary Expected COUNTRY ______________________________________________________________ MINIMUM (Rs.) __________________________ ______________________________________________________________ __________________________ 17. Knowledge of Other Language 1 - Arabic 2 - English 3 - French 4 - German 5 - Spanish 6 - Hindi 7 - Urdu 1- To Read 2- To Write 3- To Speak 18. Previous Assignment Abroad Y-Yes N-No If “Y” give no. of months 19. Have you ever been Medically Unfit? Y-Yes N-No Y-Yes N-No 20. Have you ever denied overseas assignment? 1- Personal Problem 2- 2-Health reason 3- Others 21. if Yes give reason 22. Name and Addresses of two persons Known to you Declaration 1. I certify that the particulars furnished by me are correct and I am aware that I will be held responsible for any information in the above. 2. I agree to abide by the conditions of Registration given overleaf and any other changes made thereon from time to time. Place: Date: Signature of Applicant For Office use only The details of the candidate are verified and application ID allotted. ……………………………… Facilitation Manager, RSLDCL CONDITIONS OF REGISTRATION 1. Separate Data Sheet should be used for each post. 2. Enclose along with your data sheet Xerox Copies of your Certificates and testimonials in triplicate in support of your educational/technical qualifications and experience. PLEASE DO NOT SEND ORIGINALS. 3. Please note that if you do not possess a minimum of 2 year experience in the post for which you make your application and/or if you do not possess a valid passport and/or if you fail to enclose copies of certificate in support of your qualification/experience, your Data Sheet will be kept in dormant Section until you acquire the above and produce evidence thereof. 4. Your initial registration will be valid only for a period of two years and if you desire to keep your registration alive, you should renew your registration by remitting the prescribed renewal fee. 5. Please note that mere registration of your name with this organization DOES NOT GUARANTEE YOU ANY EMPLOYMENT ABROAD. 6. No .T.A., D.A., is admissible for attending interviews. 7. If your fail to attend 2 interviews successively without any valid reason, your name will be removed from the Data Bank and no further interview will be provided to you. 8. If you are found not suitable for the post even after three interviews, your name will be deleted from the Data Bank. 9. If your are selected for a post and decline to accept the offer without valid reason, your name will be removed from the Data Bank. 10. In case of your selection, you should pay to this organization service charge as fixed by it from time to time. 11. After your selection for a post, if you refuse to take up the assignment (a) before the issue of Visa, Rs. 2500/- or 50% of the service charges Whichever is higher shall be recovered from you towards administrative charges,(b) after issue of Visa of Visa stamping, the entire amount of service charge shall be forfeited. In case where you could not be deployed for reasons not attributable to you but due to administrative reasons such as cancellation of offer by the employer, non-receipt of Government orders (In case of Government Servants), etc, the service charge paid by you shall be refunded after deducting the expenditure actually incurred by the organization for visa stamping attestation of certificates, etc. In addition to it, an amount equivalent to 10% of the service charges paid by you shall also be deducted towards administrative/ recruitment expenses incurred by the organization. SIGNATURE OF APPLICANT