8/28/2015

CommonRecruitmentProcessforRecruitmentinClericalcadre(CWEClerksV)ApplicationFormPrint

CommonRecruitmentProcess(CRP)forRecruitmentofClerks
inParticipatingOrganizations(CWEClerksV)

RegistrationNumber

: 1420918061

FullName

: PrachiJain

Category

: GENERAL

AreyouaPersonwithDisability

: NO

TypeofDisability

PercentageofDisability

Areyousufferingfromcerebralpalsyandyourwritingspeedis
affected?

IfYes,Doyouneedcompensatorytimeatthetimeofexamination?

Whetheryourdominant(Writing)handisaffected?

IfYes,Doyouneedcompensatorytimeatthetimeofexamination?

Doyouintendtousetheservicesofascribe(onlyforVIcandidates
andthecandidateswhosewritingspeedispermanentlyaffected)?

Areyouachild/familymemberofthosewhodiedin1984riots?

: NO

AreyouapersondomiciledintheStateofJammu&Kashmirduring
theperiod111980to31121989?

: NO

Religiontowhichyoubelong

: Jain

DoyoubelongtoReligiousMinorityCommunity?

: YES

AreyouanExServiceman?

: NO

AreyouaDisabledExServiceman(DISXS)?

Actualservicerenderedindefenceserviceswhichmaybecountedfor
qualifyingasanExserviceman(InMonths)

Dateofrelieffromdefenceservices:

HaveyoujoinedaGovernmentjobonthecivilsideafteravailingofthe
benefitsgivenasanexserviceman?

AreyouaDependentofServicemankilledinAction(DXS)?

: NO

AreyouamatriculateExServicemencandidate,whohasobtainedthe
IndianArmySpecialCertificateofEducationorcorresponding
CertificateintheNavyortheAirForceafterhavingcompletednotless
than15yearsofserviceinArmedForcesoftheUnionason
01.09.2015?

PercentageofMarks

Areyouseekingrelaxationunderwidow/divorcedwomen/women
judiciallySeparatedfromtheirhusbandsandwhoarenotremarried?

: NO

WhetherRegularEmployeesoftheUnionCarbideFactory,Bhopal,
retrenchedfromservice(applicabletoMadhyaPradeshstateonly)?

: NO

HaveyouappliedfortheCWEforClericalCadreheldinNovember/
December2011?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldinDecember
2012?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldinDecember
2013?

: NO

http://ibps.sifyitest.com/cweclkjul15/registration_print.php?q=OWE2MzU5YmI2OWVlODdjZGExNWM1MGJmZTY4ZmJiN2V8MTQyMDkxODA2MQ==

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8/28/2015

CommonRecruitmentProcessforRecruitmentinClericalcadre(CWEClerksV)ApplicationFormPrint

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldinDecember
2014?

: YES

RegistrationNo.

Nationality/Citizenship

: Indian

DoyouholdAadharCard?:

: NO

AadharCardNo.

VacanciesofState/UTyouareapplyingfor

: Delhi

Statecode

: 20

CentreofExamination

: Delhi

ApplicationFee/Intimationcharges:
PaymentIn

: ONLINE

Amount

: 600.00

PaymentStatus

: UNPAID

PersonalDetails
DateofBirth

: 02121990

Agecompletedason01.08.2015

: 24

Gender

: FEMALE

MaritalStatus

: Unmarried

Father'sName

: Naveenkumarjain

Mother'sName

: Manjujain

Spouse'sName

AddressforCorrespondence

: 2834StreetNo.16

Address2

: VishwasNagar

District

: Delhi

State

: DELHI

Pincode

: 110032

PermanentAddress

: F268StreetNo.9
: ShastriPark

District

: Delhi

State

: DELHI

Pincode

: 110053

ContactDetails
MobileNo

: +918800737448

AlternativeNumber(MobileNo./LandlineNo.)

EmailID

: prachijain90@gmail.com

EducationalQualification(ason01.09.2015)
ExamPassed

Degree

Subject/Stream

Dateof
Passing

%ofMarks

Class/Grade

Graduation/Equivalent B.Com

Commerce

04082011

52.00

SecondClass

PostGraduation

Commerce

23092014

57.00

SecondClass

M.Com

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8/28/2015

CommonRecruitmentProcessforRecruitmentinClericalcadre(CWEClerksV)ApplicationFormPrint

DoyouhaveOperatingandworking
knowledgeincomputersystems?

: YES

DetailsofComputerKnowledge

: StudiedinHighSchool/College/Institute

: ComputerasaSubject

OtherDetails
WhetherdesirousoftakingPreExamTraining(Only
forSC/ST/ReligiousMinorityCommunities/Ex
Servicemen/DISXS/DXS/PWD)

: YES

IfYes,CentreforTraining

: NewDelhi

OrganisationinorderofPreferences

1PunjabNationalBank
2OrientalBankofCommerce
3CentralBankofIndia
4BankofIndia
5SyndicateBank
6IndianBank
7Punjab&SindBank
8BankofBaroda
9AndhraBank
10VijayaBank
11UnionBankofIndia
12UnitedBankofIndia
13CorporationBank
14CanaraBank
15BankofMaharashtra
16AllahabadBank
17IndianOverseasBank
18UCOBank
19DenaBank

Whetheranyprosecution/detention/
fine/conviction/sentenceagainstyouhasbeen
awardedbyanycourtoflawforanyoffence?

NO

Ifyes,particularsofthesame

LanguageDetails:

LanguagesKnown

Read

Write

Speak

Hindi

YES

YES

YES

English

YES

YES

YES

DECLARATION:
IherebydeclarethatallthestatementsmadeinthisapplicationareTrue,CompleteandCorrecttothebestofmyknowledgeandbelief.I
understandthatintheeventofanyinformationbeingfounduntrueorincorrectatanystageorIamnotsatisfyinganyoftheeligibility
criteriastipulated,andalsoincaseofcreatinginfluence/unduepressureregardingrecruitmentshalltantamounttocancellationofmy
candidature.

Date:24082015

SignatureofApplicant

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