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Backward Classes Welfare Department
Government of West Bengal
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Project Name
Application Form
Backward Classes Welfare and Tribal Development Department
Pre-examination Training of SC/ST candidates for entry into Group B/C/D Categories of posts in Govt./PSU services
Exam Information
Group
*
Select
Group B
Group C
Group D
Medium
*
English
Bengali
Centre
*
Select
Barasat
Baruipur
Bankura Town
Howrah
Jhargram
Asanasol
Purba Bardhaman
Medinipore Town
Tamluk
Purulia Town
Alipurduar
Suri
Coochbehar Town
Raiganj
Balurghat Town
Darjeeling Town
Jalpaiguri Town
Kalimpong
Malda Town
Krishnagar
Beherampore
Kolkata
Chinsurah
Personal Information
Name
*
Date of Birth
*
Gender
Male
Female
Transgender
Community
*
Select
SC
ST
Mobile No
*
Email
*
Aadhaar No
*
Father's Name
*
Father' s Occupation
*
Mother's Name
*
Mother's Occupation
*
Guardian's Name
Guardian's Occupation
Annual Family Income
*
Correspondence Address Information
Correspondence Address
*
District
*
Select
NORTH 24 PARGANAS
PURBA MEDINIPUR
HOWRAH
SOUTH 24 PARGANAS
NADIA
MURSHIDABAD
PURBA BARDHAMAN
BIRBHUM
BANKURA
HOOGHLY
PASCHIM MEDINIPUR
PURULIA
JALPAIGURI
COOCHBIHAR
UTTAR DINAJPUR
DAKSHIN DINAJPUR
MALDAH
KOLKATA
GTA DARJEELING
SILIGURI DARJEELING
ALIPURDUAR
PASCHIM BARDHAMAN
JHARGRAM
KALIMPONG
Post Office
*
Block/Municipality Name
*
Select
PIN
*
Permanent Address Information
Permanent Address
*
District
*
Select
NORTH 24 PARGANAS
PURBA MEDINIPUR
HOWRAH
SOUTH 24 PARGANAS
NADIA
MURSHIDABAD
PURBA BARDHAMAN
BIRBHUM
BANKURA
HOOGHLY
PASCHIM MEDINIPUR
PURULIA
JALPAIGURI
COOCHBIHAR
UTTAR DINAJPUR
DAKSHIN DINAJPUR
MALDAH
KOLKATA
GTA DARJEELING
SILIGURI DARJEELING
ALIPURDUAR
PASCHIM BARDHAMAN
JHARGRAM
KALIMPONG
Post Office
*
Block/Municipality Name
*
Select
PIN
*
Guardian's Address Information
Guardian's Address
District
*
Select
NORTH 24 PARGANAS
PURBA MEDINIPUR
HOWRAH
SOUTH 24 PARGANAS
NADIA
MURSHIDABAD
PURBA BARDHAMAN
BIRBHUM
BANKURA
HOOGHLY
PASCHIM MEDINIPUR
PURULIA
JALPAIGURI
COOCHBIHAR
UTTAR DINAJPUR
DAKSHIN DINAJPUR
MALDAH
KOLKATA
GTA DARJEELING
SILIGURI DARJEELING
ALIPURDUAR
PASCHIM BARDHAMAN
JHARGRAM
KALIMPONG
Post Office
Block/Municipality Name
Select
PIN
Examination Passed
*
Sl No
Examination Name
Year
Marks
% of Marks
Name of Institution
1
8th Standard
2
Madhyamik
3
Higher Secondary
4
Graduation
Employment Information and Documents Upload
Present Status(If Employed)
Organization Name
Passport Size Photo of Candidate
*
(Format JPEG and Maxsize 100KB)
Signature
*
(Format JPEG and Maxsize 100KB)
Upload Marksheet of Last Exam Pass
*
*
(Format JPEG and Maxsize 100KB)
Upload Certificate of Last Exam Pass
*
(Format JPEG and Maxsize 100KB)
Upload Image of Aadhaar Card
*
(Format JPEG and Maxsize 100KB)
Upload Income Certificate
*
(Format JPEG and Maxsize 100KB)
I do solemnly declare that all the particulars given above are true. I shall abide by the guidelines of the Backward classes Welfare and tribal Development Department, Government of West Bengal.
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