9/7/2016

CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)ApplicationFormPrint

InstituteofBankingPersonnelSelection
CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)

RegistrationNumber

: 1481373431

FullName

: YogarajJ

Category

: GENERAL

AreyouaPersonwithDisability

: YES

TypeofDisability

: OC

Percentageofdisability

: morethan40%

Areyousufferingfromcerebralpalsyandyourwritingspeed
isaffected

: NO

IfYes,Doyouneedcompensatorytimeatthetimeof
examination?

Whetheryourdominant(Writing)handisaffected

: NO

IfYes,Doyouneedcompensatorytimeatthetimeof
examination?

Doyouintendtousetheservicesofascribe(onlyforVI
candidatesandthecandidateswhosewritingspeedis
permanentlyaffected)?

: NO

Areyouachild/familymemberofthosewhodiedin1984
riots?

: NO

AreyouapersondomiciledintheStateofJammu&Kashmir
duringtheperiod111980to31121989?

: NO

Religiontowhichyoubelong

: Hindu

DoyoubelongtoReligiousMinorityCommunity?

: NO

AreyouanExServiceman:?

AreyouaDisabledExServiceman(DISXS)?

: NO

Actualservicerenderedindefenceserviceswhichmaybe
countedforqualifyingasanExserviceman(InMonths)

Dateofrelieffromdefenceservices

HaveyoujoinedaGovernmentjobonthecivilsideafter
availingofthebenefitsgivenasanexserviceman?

AreyouaDependentofServicemankilledinAction(DXS)?

: NO

AreyouamatriculateExServicemencandidate,whohas
obtainedtheIndianArmySpecialCertificateofEducationor
correspondingCertificateintheNavyortheAirForceafter
havingcompletednotlessthan15yearsofserviceinArmed
ForcesoftheUnionason12.09.2016?

PercentageofMarks

Areyouseekingrelaxationunderwidow/divorcedwomen/
womenjudiciallySeparatedfromtheirhusbandsandwho
arenotremarried?

: NO

WhetherRegularEmployeesoftheUnionCarbideFactory,

: NO

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CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)ApplicationFormPrint

Bhopal,retrenchedfromservice(applicabletoMadhya
Pradeshstateonly)?
HaveyouappliedfortheCWEforClericalCadreheldin
November/December2011?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldin
December2012?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldin
December2013?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldin
December2014?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldin
December2015?

: YES

RegistrationNo.

: 1420038122

Nationality/Citizenship

: Indian

DoyouholdAadharCard?

: YES

AadharCardNo.

: 868689304618

VacanciesofState/UTyouareapplyingfor

: Tamilnadu

Statecode

: 41

CentreofExamination

: Chennai

ApplicationFee/Intimationcharges
Amount

: 100.00

PaymentStatus

: PAID

ReferenceID

: GSMP4734290553

TransactionDate

: 07092016

PersonalDetails
DateofBirth

: 27021992

Agecompletedason01.08.2016

: 24

Gender

: MALE

MaritalStatus

: Unmarried

Father'sName

: Janarthanan

Mother'sName

: geetha

Spouse'sName

AddressforCorrespondence

: 2annairaanistreet

Address2

: katterikuppam

Address3

: puducherry

District

: Puducherry

State

: PUDUCHERRY

Pincode

: 605502

Permanentaddress

: 2annairaanistreet

Address2

: katterikuppam

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CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)ApplicationFormPrint

Address3

: puducherry

District

: Puducherry

State

: PUDUCHERRY

Pincode

: 605502

ContactDetails
MobileNo

: +919943391976

AlternativeNumber
(MobileNo/LandlineNo)

: +919442132049

EmailID

: yogaraj_janarthanan@hotmail.com

EducationalQualification(ason12.09.2016)
ExamPassed

Degree

Subject/Stream

Dateof
Passing

%ofMarks

Class/Grade

Graduation/Equivalent

B.Tech.

Engineering

22082014

59.00

SecondClass

DoyouhaveOperatingandworking
knowledgeincomputersystems:?

: YES

DetailsofComputerKnowledge:

: StudiedinHighSchool/College/Institute

: ComputerasaSubject

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

: NO

IfYes,CentreforTraining

OrganisationPreference

OrganisationinorderofPreferences

Whetheranyprosecution/detention/
fine/conviction/sentenceagainstyouhasbeen
awardedbyanycourtoflawforanyoffence?

1CanaraBank
2PunjabNationalBank
3CentralBankofIndia
4UnionBankofIndia
5AndhraBank
6SyndicateBank
7BankofBaroda
8VijayaBank
9UCOBank
10BankofIndia
11OrientalBankofCommerce
12CorporationBank
13DenaBank
14AllahabadBank
15Punjab&SindBank
16IndianBank
17IndianOverseasBank
18UnitedBankofIndia
19BankofMaharashtra
:
NO

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CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)ApplicationFormPrint

Ifyes,particularsofthesame

OtherDetails:

LanguagesKnown

Read

Write

Speak

Tamil

YES

YES

YES

English

YES

YES

YES

Declaration:
Iyogarajhavefilledintheonlineapplicationformdetailsonbehalfofthecandidate[YogarajJ].Thecandidateherebydeclaresthat"all
thestatementsmadeinthisapplicationaretrue,completeandcorrecttothebestofmyknowledgeandbelief.Iunderstandthatintheevent
ofanyinformationbeingfounduntrueorincorrectatanystage/intheeventanycircumstanceswhichmayimpairmyfitnessforemployment
inBankdonotsatisfyanyoftheeligibilitycriteriastipulated,andalsodeclarethatincaseofcreatinginfluence/unduepressureonmy
behalfregardingrecruitmentshalltantamounttocancellationofmycandidature".

Date:07092016

SignatureofApplicant

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