07/03/2017

PRESIDENT'S SECRETARIAT
Name of the Post Applied : Sports Attendant
Registration No. : 1200000402
1) Name : Dheeraj Kumar
Father's
2) : S M Mahto
Name/Husband's Name
3) Mother Name : Jiria Devi
4) Gender : Male
5) Marital Status : Single
6) Nationality : Indian
7) Date of Birth : 12/05/1996
8) Category : OBC
Are you ExServiceMan : NO
H-100, Kali Bari Marg,
9) Premanent Address :
New Delhi
New Delhi
Delhi (UT)
110001
H-100, Kali Bari Marg,
10) Present Address :
New Delhi
New Delhi
Delhi (UT)
110001
11) Mobile No. : 9868135701
12) Email : ajaybioinfo@gmail.com
13) Details of Educational Qualification
Exam Board / Duration of Year of % of
Subject Studied
Passed University Study (in Years) Passing Marks
Hindi, English, Social Science,
Matric CBSE 1 2012 50
Mathematics, Science
English, Hindi, History, Political
Intermediate CBSE 1 2014 66
Science, Physical Education
Graduation
Post
Graduation

14) Details of Certificate for Participation at the State / National Level in any Sports / Games
Name of Participation in State / Duration of Duration of Year of
Remarks
Game / Sport National Level participation from participation upto participation
Bronze
BOXING State 23/10/2015 30/10/2015 2015
Medal
Gold
BOXING State 01/08/2016 03/01/2016 2016
Medal

Details of Experience
Name of Name of Govt. Post Pay Duration of Nature of duties
Upto
Game / Sport Organisation / Institution held Scale experience from performed

1/2

I understand that in the event of any information being found false or incorrect at any stage or not satisfying the eligibility conditions according to the requirements mentioned in the advertisement. complete and correct to the best of my knowledge and belief. Place : New Delhi Date : 07/03/2017 (Sig. of Canditate) 2/2 . my candidature / appointment is liable to be cancelled / terminated.07/03/2017 Details of Enclosure : 1) Matric Certificate 2) Intermediate Certificate 3) Photo 4) Signature 5) Date of birth Proof 6) Course certificate1 7) Course certificate2 I declare that I fulfil the eligibility conditions as per the advertisement and that all the statements made in this application are true.

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