FORML. Con. A [See rule 30(2)] Application for grant of conductor's license Full name and ____________________ Address of the ____________________ Applicant _________________________ To, The Licensing Authority 1. I here by apply for the grant of a conductor's license to act as a conductor of stage carriage, within the State of Gujarat. 2. I here with attach -- (i) the proof of age, the date of birth being _________________ (ii) the proof of educational qualification having passed ___________ standard examination (iii) the Adult First Aid certificate No. _________ issued by St.John Ambulance Association (India) ______________Branch and valid up to (iv) the report of moral character obtained from _________________ police station, dated __________________ (v) two copis of recent photograph (vi) the medical certificate in Form M.C.Com. 3. I here by declare- (i) That I have the following convictions ___________ (ii) That I have previously held a conductor's licence issued by ____________not previously held a conductor's licence. (iii) that I am not disqualified for holding a conductor's licence. 4. I here with tender the fee for test prescribed in rule 26 Date ________________ Place________________ Specimen signature of applicant. Signature of applicant. * Strike out whichever is either not required or not applicant.
