Search Site
Breaking News :   Recruitment for the post of Upper Division Clerk & Multi Tasking Staff - 2011-12. To Apply online visit Recruitment section. Last date to submit system generated Application (to be generated upto 31/01/2012 upto 5:00 p.m.) is 15/02/2012.
 
ESI Scheme
Rules & Regulations
Benefits under ESI
Medical Reimbursement
Branch Offices List
Dispensary List
Hospital List
Panel of Doctors
Facilities
ESIC News
Photo Gallery
Tenders
Forms
Recruitment
 
 
Online Application (Upper Division Clerk)
 
Click here to download Terms & Conditions
For best results use browser IE 7.0+ & Mozilla Firefox
* - Required fields
Name
First name: *
Middle Name:
Last Name: *
   
Center Panaji, Goa
   
Gender: * Female Male Others
   
Father's / Husband's Name: *
   
Date of Birth: *
   
Are you a citizen of India: * Yes No
   
Permanent Address
Permanent Address
Address: *
City: *
Taluka:
District:
State: *
Pincode: *
  Mailing address same as Permanent Address.
Mailing Address
Mailing Address
Address: *
City: *
Taluka:
District:
State: *
Pincode: *
   
Email Address
   
Mobile Number
   
Category: * General OBC SC ST PWD
Other Categories PH Ex-Serviceman Departmental Candidate Government Servant
   
   
Educational Qualifications(From matriculation onwards including computer knowledge) *
Sr. No. Qualifications University/Board Subject Studied Percentage Remarks
1
   
Experience/particulars of previous and present employment(if any)
Sr. No. Name   full address of Employer Designation/Duties of post Scale of pay Period of Employment From Period of Employment to
1
   
Medium of Examination for computer skill test: *
Details of other chievements,extra curricular activities, and professional achievements if any (300 characters maximum)
Enter the text in the box:
I Agree to the terms and Conditions. Click here to download Terms & Conditions
 
Home l About Us l ESI Act l Photo Gallery l Benefits l Tenders l Contact Us l Feedback