APPLICATION FOR WEST BENGAL CIVIL SERVICE (EXE.) ETC. EXAMINATION, 2019 (ADVERTISEMENT NO.

29/2018)

REGISTRATION NO: PSCWB03140772171 PAYMENT ID: CPSC31407720820c

Enrolment No: PSC03111526

Candidate Name: SUBHADIP GHOSH
Father's Name: KALOMANIK GHOSH
Mother's Name: CHHABI GHOSH
Place of Birth: SURI
Do you have ability to read, write and speak YES
in Bengali:
Whether your mother tongue is Nepali ? : YES
State your mother tongue: BENGLAI
Do you belong to Race such as Nepali, NO
Garhwali, Gorkha, Assamese Tribals, etc.? :
Date of Birth: 10. January .1996
State your choice of language in Paper - I : Bengali
Height (cm.): 165

Sex MALE Physically Challenged: NO

Nationality Indian Were you debarred previously by the NO
Commission from appearing at any
Category General
examination/selection ?:
Email Id: amisubhadip96@gmail.com

Address For Correspondence   Permanent Address  

Address : VILL-KUBIRPUR Address : VILL-KUBIRPUR
  P.O-HATJANBAZAR   P.O-HATJANBAZAR
  P.S-SURI   P.S-SURI
State: West Bengal State : West Bengal
District : Birbhum District : Birbhum
Pin: 731102 Pin: 731102
Mobile No. 7872313832 Mobile No. 7872313832

Academic Qualifications (Madhyamik or equivalent and onwards)

Examination Examination Year of Passing Name of Board/Council/University Subjects Taken Division/Class/Grade Marks % Remarks
Name
BENGALI I, BENGLAI II, ENGLISH,
Class 10th or MATHEMATICS, PHYSICAL
MADHYAMIK 2011 WBBSE 1st 60
equivalent SCIENCE, LIFE SCIENCE,
HISTORY, GEOGRAPHY

Class 12th or HIGHER BENGALI, ENGLISH,

2013 WBCHSE MATHEMATICS, PHYSICS, 2nd 58.8
equivalent SECONDARY
CHEMISTORY, BIOLOGY
Graduation PHYSICS, CHEMISTORY,
(Bachelor B.SC 2017 UNIVERSITY OF BURDWAN MATHEMATICS 3rd 44.50
Degree)

Experience
Have you at any time been employed ? NO
Any other information :
Center Preference  
Preference Burdwan Optional paper Political Science

Group applied for  

GROUP A - West Bengal Civil Service (Exe.) etc. Examination, 2019 (Advertisement No.29/2018)
GROUP B - West Bengal Civil Service (Exe.) etc. Examination, 2019 (Advertisement No.29/2018)
GROUP C - West Bengal Civil Service (Exe.) etc. Examination, 2019 (Advertisement No.29/2018)
GROUP D - West Bengal Civil Service (Exe.) etc. Examination, 2019 (Advertisement No.29/2018)
Optional paper : Political Science

I solemnly declare that :

a) I am eligible to apply for the examination as per the notification.
b) All statements made in this application are true, complete and correct.
c) Original documents will be produced on demand.
d) I agree to take this examination on the condition that the Commission may cancel my candidature if at any stage I am
found ineligible.

I have obtained all my certificates (Qualification, Disability Certificate and/or Caste) within the date of submission of my
application.
I have informed the Head of my Office or Department in writing that I am appling for this examination (Please click the box if you are in service of Govt. or Local or Statutory Body).

I agree that all the information provided here, are correct according to my knowledge
PLEASE REVIEW THE ABOVE DETAILS CAREFULLY FOR ANY ERRORS BEFORE CONFIRMING SUBMISSION.

YOU WILL NOT BE ABLE TO MAKE ANY CHANGE AFTER CONFIRMATION OF SUBMISSION
THE FORM WOULD BE CONSIDERED SUCCESSFULLY SUBMITTED ONLY AFTER PAYMENT OF EXAMINATION FEE ( IF APPLICABLE)
PLEASE DOWNLOAD YOUR ADMIT CARD BEFORE EXAMINATION

Date : 22-11-2018

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