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ON-LINE APPLICATION FOR TNPSC REGISTRATION

45031
Registration # :

507287295

Notification. No. :

07/2015

Full Name :

A SIVAJOTHI

Do you have One Time Registration ID? :

NO

Name of The Post Applying for :

Posts included in
Combined Civil Services
Examination - II (Interview
posts )(Group-II services)

Are you a Destitute Widow? :

NA

Are you a Differently Abled Person? :

NO

Are you an Ex-Serviceman ? :

NO

Date of Enrolment :

--

PPO No :

--

Date of Discharge / Probable date of Discharge :

--

Are you a Government Employee? :

NO

Have you been debarred by the Public Service Commission or any other recruiting agency? : NO
Are you a retrenched Technical or Non-Technical Employee of TANSI and not
absorbed in Government Corporation or Undertaking? :

NO

Nationality :

Indian

Application Fee/Examination Fee/Intimation Charge details:

Payment Mode:

Net Banking

Amount :

125.00

Personal Details :
Date of Birth :

31/08/1990

Gender :

MALE

Marital Status :

UnMarried

Religion :

Hindu

Candidate's Place of Birth :

THANJAVUR

Native District :

Thanjavur

Father's Name :

G ANBARASU

Father's Place of Birth :

Tiruvarur

Mother Tongue :

Tamil

Mother's Name :

A ILAVARASI

Communal Category :

Backward Class(BC)

Name of the SubCaste :

Vaniyar

Certificate No :

4469097

Date Of Issue :

08/11/2002

Issuing Authority :

Zonal Deputy Tahsildar

Taluk :

Thanjavur

District :

Thanjavur

Address for Correspondence :

66 SELVAVINAYAGAR KOVIL STREET

MELA THERU, T.N.PUTHUKUDI
PULIYANGUDI, SIVAGIRI TALUK

District

Tirunelvelli

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State :

Tamil Nadu

Pincode :

627855

Permanent Address :

66 SELVAVINAYAGAR KOVIL STREET

MELA THERU, T.N.PUTHUKUDI
PULIYANGUDI, SIVAGIRI TALUK

District

Tirunelvelli

State :

Tamil Nadu

Pincode :

627855

Contact Details :
Email ID :

seatigersiva@gmail.com

Mobile No :

9944879876

EDUCATIONAL QUALIFICATION PARTICULARS :

Exam Passed

Date of
Publication of

S.S.L.C :

05/06/2006

H.S.C / ITI (2
years) /
Teacher
Training (2
years) :

09/05/2008

Degree :

26/04/2012

Post Graduate
Degree :

08/06/2014

Medium of
Instruction

Degree

Major Subject

Certificate No Board / University

English

N/A

N/A

0491277

N/A

3688692

Results

English

H.S.C

English

B.E.

English

M.E.

MATRICULATION

STATE BOARD

CIVIL
ENGINEERING

03034

PERIYAR
MANIAMMAI
UNIVERSITY

GEOTECHNICAL
ENGINEERING

610618

ANNA UNIVERSITY

Class / Grade obtained in UG Degree :

FIRST CLASS WITH DISTINCTION

Do you claim reservation for Persons Studied in Tamil Medium (PSTM)? :

NA

Whether you are applying with the Educational Qualification as Prescribed in the notification
Prescribed Qualification
or with an equivalent qualification :
Details regarding the prescribed qualification :
Master's Degree in Computer Application / Master's Degree in Science (Information
Technology / Computer Science)

No

Any other Master's degree /IPG Degree

Yes

Any Bachelor's Degree

Yes

Any Bachelor's Degree with Typewriting in Higher/ Senior Grade in both Tamil and English

NA

PG Diploma in Agriculture Economics and Co-operation

No

Diploma in Rural service / Diploma associate member of the Institute Chartered Accountant.

No

Diploma in Handloom Technology / Textile Technology / Textile Processing / Man made

Fibre Technology

No

Do you possess any preferential qualification as per Notification? :

No

Qualification with Major

subject

Medium of
Instruction

Date of Publication of
Results

Board/University

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

Are you rendered any social welfare work for a period of not less than one year? :

No

Are you Released Emergency Commissioned Officer? :

No

Are you released Short Service Regular Commissioned Officer? :

No

Technical Qualification Particulars :

Certificate No.

Date of Issue

Board/Authority

Typewriting Tamil

--

Grade

--

--

--

Typewriting English

--

--

--

--

Shorthand Tamil

--

--

--

--

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Shorthand English

--

--

--

--

Book keeping

--

--

--

--

Do you have the Physical Standards as per notification :

Yes

EXAMINATION PARTICULARS :
Name of the Examination Centre :

Thanjavur

Optional Subject :

General Studies ( Degree standard) and General English (SSLC standard)

Do you claim Age Concession? :

No

Do you claim fee concession for payment of Examination fee? :

No

Criminal Case (Registered/Pending/Punishment awarded/Acquitted) :

No

Participation in Political Activities (In agitation/As a Member of Political

Organisation/Candidature in Election) :

No

Experience Details :
Name of the Organisation

Designation

From(dd/mm/yyyy)

To(dd/mm/yyyy)

Nature of Duty

Previous appearance for Oral Test / Written Test

Name of the Post

Register No.

Year

--

--

--

--

--

--

DECLARATION:
1. I hereby declare that all the particulars furnished in this application are true, correct and complete to the best of my knowledge and belief. In the event of any information being found false or
incorrect or ineligibility being detected before or after the examination, action can be taken against me by the TNPSC.
2. I hereby declare that I will not be a party to any kind of canvassing on my behalf.

3. I further declare that I fulfil all the eligibility conditions prescribed for admission to the examination.

4. I have informed my employer in writing that I am applying for this Examination.

5. I have gone through the instructions to candidates and the Commission's notification for this Recruitment before filling up the application form.

6.I declare that I possess the Physical standards prescribed for the post(s) which I am now applying.

7. I Certify that I have not been debarred / disqualified by the TNPSC or any other recruiting agency.

8. I am not a dismissed Government Employee.

I accept the above said declarations

Place:

Last Updated Date: 2015-05-20 09:29:25

Note: Please retain your Registration No. and Password emailed to you carefully for further reference

Signature of Applicant