PUNJAB NATIONAL BANK - RECRUITMENT OF SPECIALIST OFFICERS

ONLINE APPLICATION FORM FOR THE POST OF SPECIALIST OFFICERS

15032

Registration # : 112380 Please paste your

recent passport size
photograph and sign
Full Name : NAVEEN KUMAR BAIRAGI across it.Please retain
atleast 5 copies with
you for subsequent
Post : Officer Industry use.

Specialization : Electrical

Category : OBC

Person With Disability : NO

Type of Disability : -- Percentage of Disability: --

Do you intend to use the services of a --

scribe :

Whether domiciled in Kashmir Division of NO

the State of J&K during the period
1-1-1980 to 31-12-1989 :
Belongs to Religious Minority Community : NO Minority Religion : --

Whether Children / Family members of NO

those who died in 1984 riots?

Are you an Ex-Serviceman ? NO

Whether an Employee of PNB? NO PF No : -

Whether applied for another post? NO

Name of the additional post applied : -

Nationality : INDIAN

Centre of Examination : Delhi Centre code : 13

Application Fee Details :

Transaction Id : M 373350

Branch Name : VIJAY NAGAR NEW Branch Code : 1524

DELHI

Deposit Date : 03/09/10 Amount : 400

Personal Details :
Date of Birth : 13/02/1988 Age as on 01.07.2010 : 22

Gender : Male

Father’s Name : P R BAIRAGI

Mother’s Name : SUSHILA RANI

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Email ID : naveen.bairagi@gmail.com

Address for Correspondence : Hno. 140-D GALI NO.2 NAND VIHAR

BEHIND CHAUDHRY HOSPITAL

JATTAL ROAD

District : PANIPAT

State : HARYANA Pin: 132103

Permanent Address: Hno. 140-D GALI NO.2 NAND VIHAR

BEHIND CHAUDHRY HOSPITAL

JATTAL ROAD

District : PANIPAT

State : HARYANA Pin : 132103

Phone : 0180-2688600 Mobile : 9803347505

Qualification Details(as on 18.08.2010):

Exams Passed Subject / Stream Specialization Year Of Passing % of Marks Grade
HSC : SCIENCE -- 2006 76.60 First Class
Graduation : BE Electrical 2010 69.04 First Class
Post Graduation : -- -- -- -- --
Professional -- -- -- -- --
Qualification :
Diploma : -- -- -- -- --

Working Knowledge of MS Office : YES

Post Qualification work experience details as on 18.08.2010 (Start from present Employer):
No Working Experience
DECLARATION:
I hereby certify that the above information furnished is correct to the best of my knowledge and belief. I have not suppressed any material fact or
factual information in the above statement. I am aware that in case I have given wrong information or suppressed any material fact or factual
information or I do not satisfy the eligibility criteria according to the advertisement, then my candidature will be rejected/services terminated
even after permanent employment without giving any notice or reasons thereof.
I hereby certify that I am satisfying the eligibility criteria for the post applied for in terms of the advised criteria in respect of age, educational
qualification and experience etc.
I am also willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part of the country and/or to any job position
at its sole discretion in terms of applicable staff rules from time to time.
I hereby agree that any legal proceeding in respect of any matter or claims or disputes arising out of application or out of said advertisement can
be instituted by me only at New Delhi only, shall have sole and exclusive jurisdiction to try any cause/dispute. I undertake to abide by all the
terms and conditions in the advertisement given by the Bank.

Place : Signature of Applicant

Date : 03/09/10

NAVEEN KUMAR BAIRAGI

Please retain your Registration No. and Password emailed to you carefully for further reference.
NOTE: Please DO NOT SEND application print-out to the Bank

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