Department of Tourism, Government of Goa, Panaji-Goa Tel: 0832 2494200/209 Fax: 0832 2494227 E-Mail: Web: Application Form

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DEPARTMENT OF TOURISM, GOVERNMENT OF GOA, PANAJI-GOA

Tel: 0832 2494200/209 Fax: 0832 2494227


E-mail: dir-tour.goa@nic.in Web: www.goatourism.gov.in
APPLICATION FORM
Advertisement number

Paste passport sixe


photograph & put
signature half on
the photograph
and half on the
application form

Name of the post _______________________________________

FULL NAME
(In Capital)

Address

Contact No.

Date of Birth and


age as on date of
Advertisement

Sex

Nationality

Educational
Qualification

Valid Employment
Registration No.

Category

:
15 yrs. Valid
residential
Certificate

Language Known

Experience if any

Date of
Birth:

Gen

Age:-

SC

ST

OBC

Phy.
Handicapped

ExServiceman

CFF

(i)

(ii)
(iii)

(iv)

(v)

Declaration
I hereby declare that I have read and fully understood the instructions and guidelines contained in the
Notification issued by the Department concerned, in respect of the advertisement and the scheme
for recruitment to the post applied for.
I further declare that all the statements made in this application form are true and correct to the best of
my knowledge and belief.
I further declare that all the copies of the documents/certificates attached to this application form in
support of my application to the post applied for, are true copies of the original
documents/certificates and the same are not false or fabricated.
I understand that in the event of any information furnished or certificates attached by me, are found to
be false or incorrect, my candidature for the post applied for is liable to be cancelled/rejected even
after selection.
I understand that I shall be held liable and for the consequences thereon, for any false declaration
made or false certificates attached.

Signature of the Applicant


Place:Date :-

Enclose Self certified certificates copies and tick mark () against the same whichever submitted.
1.

Birth Certificate

2.

15 years Residential Certificate

3.

Valid Employment Registration Card

4.

Educational Certificates

5.

Other courses of qualifications

6.

Cast certificate

7.

Experience, if any

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