Application of Job: SSC [SSC{GS(X)}],SSC [SSC(HYDRO)],SSC [GS(ENGINEERING)],SSC

[GS(ELECTRICAL)] - 01/2018

Application No: SGH181M000795 Application Date: 21/02/2017

PRIORITY

1. SSC [SSC(HYDRO)] 01/2018

2. SSC [GS(ENGINEERING)] 01/2018
3. SSC [SSC{GS(X)}] 01/2018
4. SSC [GS(ELECTRICAL)] 01/2018

PERSONAL PARTICULARS

Name: ROMI MALIK

Father's Name: BHAGWAN DEV
Guardian's Name: BHAGWAN DEV
A MARK OF ELECTRIC SHOCK
Identication Mark 1:
ON RIGHT HAND PALM
Identication Mark 2: ---------
Nationality: INDIAN
Aadhaar No.: 731437323020
Date of Birth: 02/04/1994

EDUCATION PARTICULARS

Details of MBA Qualication

Details of
MBA Qualication Type: REGULAR
Qualication:
Obtained
Total Marks: 1500 Obtained Marks: 905 60.33
Percentage:
Year of Passing: 2017
KURUKSHETRA KURUKSHETRA INSTITUTE
University Name: UNIVERSITY, Collage Name: OF TECHNOLOGY AND
KURUKSHETRA MANAGEMENT
College State: HARYANA College District: ROHTAK

Details of B.Tech Qualication

Details of
B.TECH Qualication Type: REGULAR
Qualication:
 Semesters Total Marks Obtained Marks

Semester 1 1100 671

Semester 2 1175 774

Semester 3 1150 770

Semester 4 1150 792

Semester 5 1100 726

Grand Total 5675 3733

Percentage 65.78

Year of Passing: 2015

MAHARISHI
UNIVERSITY INSTITUTE OF
DAYANAND
University Name: Collage Name: ENGINEERING AND
UNIVERSITY
TECHNOLOGY,ROHTAK
ROHTAK
College State: HARYANA College District: ROHTAK

Details of 12th Qualication

12th Standard Serial no. of

77% 079179
Percentage: Marksheet:
State Conducted Board Conducted
HARYANA State Board
Exam: Exam:

Details of 10th Qualication

State Conducted Board Conducted Serial no. of

DELHI CBSE 0203748
Exam: Exam: Marksheet:

MILITARY RECORD

Have you ever been enrolled in Armed Forces before?: NO

Have you attended any Services Selection Board (SSB)
NO
before?:
Have you been discharged from Armed forces before?: NO

COMMUNICATION PARTICULARS

Details of Permanent Address

Address 1: 41-B/12 Address 2: RAJIV NAGAR

State: HARYANA District: ROHTAK Pincode: 124001
Domicile: HARYANA Phone No.: 8295145313 Mobile No.: 8295145313
Email id: Romimalik0204@gmail.com Alternate Email id: ---------

Details of Correspondence Address

Same as Permanent Address

Alternate Mobile Number: 8221930833

A. I hereby declare that I am unmarried, governed by nationality condition as laid down by the Government of Indian and
have never been debarred from appearing at any examination. I have never been arrested/ prosecuted and convicted by a
criminal court or involved in any other case registered by the Police.
B. I hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my
knowledge and belief.
C. I fully understand that in the event of my information being found false or incorrect, appropriate action can be taken
against me.
D. Eligibility criteria will be veried on reporting at the selection centres. I found ineligible, I understand that criminal
proceedings can be initiated against me for fraudulent entry and falsication of Government of Indian documents. I also
accept that no TA/ DA will be admissible to me in such cases.