ONLINE APPLICATION FORM FOR THE SPECIALIST OFFICERS Please check Print Preview in A4 size Portrait format with 0.25" margin from all sides (Click to Print )

To, UCO BANK Post Box No. 7478, Jogeshwari (East), MUMBAI , 400 060.

With reference to your advertisement on bank's website , I submit my application in the prescribed format. Registration # : Full Name : Post 34740 JOYDIP GHOSAL IT OFFICER- MMGS-II

: : :


GENERAL N Percentage of Disability N

Person with Disability Type of Disability :


Domiciled in Kashmir :

Belong to Religious Minority Community : N ExServicemen : Employee of UCO Bank : Centre of Exam : Name of Issuing Bank: Place of Issue: Demand Draft No: MICR No.: Date of Issue : Date of Birth : Gender : N N KOLKATA STATE BANK OF INDIA Centre code : 20

KONNAGAR 689909 000002000
23 May, 2009 03 September, 1981 MALE Application Fee : Age in completed years as on 01.04.2009 : 250 27

Post Qualification Work Experience details as on 01.04.ghosal@gmail.2 PHP DEVELOPER 01 December.com Mother's Name : SMT ARATI GHOSAL 17/D SURATH BANERJEE LANE KONNAGAR HOOGHLY WEST BENGAL State : Contact Details: STD Code 033 : Mobile No : 9331050998 Pin : 712235 Phone No : 26748027 Details of Educational Qualification:(as on 01.2009) Exams Passed Graduation Post-Graduation Professional Degree Other Subject Studied Select MCA/DOEACC – B LEVEL MCA BSc in Physics Hons Year of Passing 2007 2007 2004 % of Marks 79 79 44 17. if any Period of Service Nature of duties performed Reason for leaving services Year of Experience From (dd/mm/yyyy) ASSURGENT TECHNOLOGY SOLUTION PVT LTD DB INFO SOLUTION PVT LTD PHOTOGRAMATIST 16 August.MY SQL 0. 09 WEB DEVELOPER IN PHP.2009 Organisation Served Designation and rank.Father's Name : Email ID : Address for Correspondence : SRI JOYDEB GHOSAL joydip. 08 31 March. 07 To(dd/mm/yyyy) 13 October.04. 08 SOFTWARE DEVELOPMENT PERSONAL 1.30 Whether desirous of using services fo scribe:(only for VI and OC both hands affected by cerebral palsy): N .

and Password carefully for further reference. complete and correct to the best of my knowledge and belief.Declaration : I hereby declare that all the statements made in this application are true. Please retain your Registration No. my candidature/ appointment is liable to be cancelled/ terminated. I hereby agree that any legal proceedings in respect of any matter(s) or claims or disputes arising out of this application and/ or out of said advertisement can be instituted by me only in Kolkata and Courts / Tribunal/ Forums at Kolkata only shall have sole and exclusive jurisdiction to try any cause/ dispute. I also agree that Bank has the right to transfer me to any part of the country at its discretion. I understand that in the event of any information being found false or incorrect at any stage or not satisfying the eligibility criteria according to the requirements of the relative advertisement. I undertake to abide by all the terms & conditions mentioned in the advertisement given by the Bank. . Signature of the candidate Name : Place : Date : Note: • The candidate must retain the photocopy of the sent print out of application form for further reference. I am wiling to serve anywhere in INDIA.

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