Download File - Bharat Uday Mission

BIO-DATA
NAME
:
SURNAME
:
Email
:
Mobile number
:
Land line number
:
AFFIX PHOTOGRAPH
COMMUNITY DETAILS
NATIONALITY
CASTE
:
SUB-CASTE
:
RELIGION
:
OC/FC/MFC/MBC/OBC/BC/SC/ST/MINORITIES/OTHERS
:
:
PERSONAL INFORMATION
DATE OF BIRTH
:
Age as on 1-3-2014
:
Sex
Physical Status
:
:
Height
:
Mother Tongue
:
Voter ID card number
Aadhar card number
Ration card number
Marital Status
:
:
If married:
Male / Female
Normal / Physicallyhandicapped/others
Enclose Xerox copy
Enclose Xerox copy
Enclose Xerox copy
:
SPOUSE NAME
:
NUMBER OF CHILDREN
Parents information
:
Father name
:
Mother name
:
Place of residence
Parents Occupation
Income status
EDUCATIONAL INFORMATION:
Highest degree
Year of passing
Name of the university
:
:
:
:
:
:
:
BPL/LIG/MIG/UIG/HCG
* 2*
PROFESSIONAL INFORMATION:
Whether employed
:
If yes govt /private/semi-govt/NGO.etc:
Designation of Occupation/employement
:
Occupation in Detail
:
Annual Income
:
Income status
:
Below poverty line
Lower income Group.
Middle income Group
Upper income Group
High Class Group
Business Class Group
BPL
LIG
MIG
UIG
HCG
BCG
Personal Habits:
YOUR PUBLIC LIFE/PROFILE
:
YOUR POLITICAL IDEALOGY
:
Political/social/group/Non political. etc.,
YOUR POLITICAL HISTORY/REFERENCE:
SOCIAL ACTIVITIES INVOLVED
:
YOUR CONTRIBUTION TO SOCIETY :
YOUR ACHIEVEMENT IN PUBLIC/SOCIAL LIFE PLATFORM:
NAME OF THE CONSTITUENCY YOU INTEND TO CONTEST GENERAL ELECTIONS 2014:
DETAILS OF YOUR CONSTITUENCY :
Name of the state:
Name of the district:
Name of the constituency:
Population:
Majority of the people belong to:
Caste:
Religion:
community
:
How do you intend to serve your constituency through party:
*3*
Your opinion of present needs and the developmental activities to be concentrated in your
constituency category wise:
Public health:
Education:
Hygene/sanitation
Roads/Transport system
Communications
Electrification
Animal husbandary development
Old age welfare
Youth development
Child development & Women empowerment etc.,
DID YOU CONTEST ANY ELECTIONS EARLIER FROM ANY POLITICAL PARTY : yes/no
If so details :
Have you ever been charged / convicted by criminal courts in India/abroad:
If so details:
FACTORS CONTRIBUTING YOUR WINNING CHANCES IN CONSTITUENCY:
ANY OTHER SPECIFIC REASON/DETAILS TO BE MENTIONED IF ANY:
ADDRESS FOR COMMUNICATION:
Permanent Address:
Dno:
Street:
Village/mandal:
Town:
District:
State:
Present Address:
Dno:
Street:
Village/mandal:
Town:
District:
State:
I the undersigned hereby declare the above mentioned details are true to the best of my knowledge
Place :
Date
:
Signature

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