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ON-LINE APPLICATION FOR COMMON WRITTEN EXAM FOR CLERICAL CADRE
Registration # : 2002693194
Full Name :
Category : If Person with Disability : Type of Disability : Percentage of Disability : Do you intend to use the services of a scribe (only for VI & OC both hands affected by cerebral palsy) ? : Whether you Children / family members of those who died in 1984 riots? : Whether you domiciled in Kashmir Division of the State of J&K during the period 1-1-1980 to 31-12-1989? : Whether you belong to Religious Minority Community ? : Religion to which you belong : Are you an Ex-Serviceman ? : Are you a disabled Ex-Serviceman (DISXS)? : Are you a dependent of an Ex-Serviceman killed in action ? : Have you passed in one of the following Armed Forces Examinations equivalent to Civil Examination of HSc/Pre-University? : IAF Education Test for Promotion to rank of Corporal : Passing Out (Indian Navy) Examination conducted by Boys Training Establishment, Visakhapatnam :
GENERAL NO NA NO NO NO NO NO NO
Are you a matriculate Ex-Servicemen candidate, who has obtained the Indian Army Special Certificate of Education or corresponding Certificate in the Navy or the Air NO Force after having completed not less than 15 years of service in Armed Forces of the Union? : Are you seeking relaxation under widow / divorced women / women judicially Separated from their husbands and who are not re-married? : Whether Regular Employees of the Union Carbide Factory, Bhopal, retrenched from service (applicable to Madhya Pradesh state only)? : Nationality : State/ UT which the Centre of Examination Belongs : State / UT Code : Centre of Examination : Centre Code : Application Fee / Intimation Charges details: Payment Mode: Name Of Payee Bank : Transaction No. : Branch Name : DP Code / Branch Code No : Deposit Date : CBS Punjab National Bank M131382 STATION ROAD MORADABAD 034700 20-09-2011 NO NO INDIAN Uttar Pradesh 43 Bareilly 208
2011): Exam Passed SSC/Equivalent : HSC/Equivalent : Graduation/Equivalent : Other Details : Would You like to undergo Pre-Exam Training (SC/ST/Minority Community/ ExServicemen /PWD) : If Yes.2011 : Gender : Husband's Name/Father's Name : Mother's Name : Address for Correspondence : District State : Pin : Permanent Address : District State : Pin : Contact Details : Email ID : Phone No : Mobile No : Qualification Details (as on 01.com 9756372095 25-12-1991 19 MALE BHIRAMPAL SINGH SURESH DEVI VILL+POST. my candidature is liable to be cancelled. DEORHI URF HADIPUR J P NAGAR UTTAR PRADESH 244221 VILL+POST. and Password emailed to you carefully for further reference NOTE: Please DO NOT SEND application printout to IBPS . I understand that in the event of any information being found untrue or incorrect at any stage or my not satisfying any of the eligibility criteria stipulated. DEORHI URF HADIPUR J P NAGAR UTTAR PRADESH 244221 350 DECLARATION: I hereby declare that all statements made in this application are true. complete and correct to the best of my knowledge and belief.00 prince395@rediffmail. Centre for Training : Languages Known HINDI ENGLISH --Read YES YES Write YES YES Speak YES YES Subject /Stream SCIENCE SCIENCE SCIENCE Date of Passing 05-06-2006 06-06-2008 03-06-2011 % of Marks 54.08.00 53.00 50.2/2 Amount : Personal Details : Date of Birth : Age completed as on 01.08. Place: Date: 20-09-2011 Signature of Applicant Please retain your Registration No.