Similipal-Green skill development-application

Personal Details

Please provide your basic personal information.

Full name of candidate *

Father's / Husband's name *

Mother's name *

Gender *

Male Female Other

Date of birth *

Age as on 01/08/2026

Contact & Address

Please provide your contact and residential information.

Present / Correspondence Address *

Permanent address is same as present address

Permanent Address *

Mobile Number *

Alternate Number

E-mail *

Domicile & Locality

Please provide your domicile and locality information.

Permanent resident of Mayurbhanj? *

Yes No

Educational Qualification

Please provide your educational qualification details.

Qualification *	School / College / Institution Name *	Board / Council Name *	Pass Out Year *	Marks % / Grade *	Division / CGPA *	Action
Matriculation (10th)						—
12th / +2						—

Languages Known *

Please indicate your ability to read, write and speak each language.

Language	Read	Write	Speak	Action
Odia				—
Hindi				—
English				—

Category & Reservation

Please provide your category and reservation details.

Social Category *

UR ST SC SEBC

If ST, name of tribe

Whether PVTG (Particularly Vulnerable Tribal Groups) *

Yes No

Woman candidate *

Yes No

Caste / PVTG certificate No. & issuing authority

Prior Field / Forest Experience

Please provide details of your field or forest experience.

Physical Fitness

Please provide your physical fitness self-declaration.

Fit for long walks over forest terrain? *

Yes No

Any medical condition to be aware of? *

Yes No

If yes, specify

A medical fitness certificate is to be produced at the prescribed stage.

EDC / VSS Membership

Please provide your EDC / VSS membership details.

Member (self or household) of an EDC / VSS? *

Yes No

Name of EDC / VSS

Village

Socio-economic Particulars

Please provide the information required for need scoring.

BPL / Antyodaya card holder? *

Yes No

Ration card No. / Card type

Present occupation / employment status *

Unemployed Daily-wage / seasonal Student Self-employed Other

Sole earning member? *

Yes No

Total family members / No. of dependents *

Documents

Please upload the required documents and accept the declaration.

1. Proof of age * Birth certificate / Matriculation certificate. PDF only, maximum 5 MB.

2. Residence / Domicile certificate / Address proof * PDF only, maximum 5 MB.

3. Educational certificate(s) * Upload 10th, +2, Graduation, Master's or other relevant certificates. Multiple PDF files allowed, maximum 5 MB per file.

4. Caste certificate Required if applicable. PDF only, maximum 5 MB.

5. Passport size photograph * JPG, JPEG, PNG or WebP only, maximum 2 MB.

Declaration

Please read the declaration carefully before proceeding.

I hereby declare that the information furnished above is true and correct to the best of my knowledge and belief. I am of good character and I have neither been convicted of, nor is any case pending against me in respect of, any offence involving poaching, illegal hunting, trade in wildlife or wildlife articles, illicit felling or timber smuggling, the laying of traps or snares, or any other serious offence under the Wild Life (Protection) Act, 1972 or the forest laws. I understand that furnishing false information or suppression of facts will render me liable to disqualification or removal at any stage. I have read and accept the selection criteria and conditions of the programme.

I accept the above declaration. *

Similipal Tiger Reserve

Application form for Naturalist and Eco guide- A Green Skill Development Program under Ama Similipal Yojna

Personal Details

Contact & Address

Domicile & Locality

Educational Qualification

Languages Known *

Category & Reservation

Prior Field / Forest Experience

Physical Fitness

EDC / VSS Membership

Socio-economic Particulars

Documents

Declaration

Review Application

Field Director Office

Contact Details