9/11/2016

CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)ApplicationFormPrint

InstituteofBankingPersonnelSelection
CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)

RegistrationNumber

: 1482021413

FullName

: SHUBHAMPANDEY

Category

: GENERAL

AreyouaPersonwithDisability

: NO

TypeofDisability

Percentageofdisability

Areyousufferingfromcerebralpalsyandyourwritingspeedisaffected :
IfYes,Doyouneedcompensatorytimeatthetimeofexamination?

Whetheryourdominant(Writing)handisaffected

IfYes,Doyouneedcompensatorytimeatthetimeofexamination?

Doyouintendtousetheservicesofascribe(onlyforVIcandidates
andthecandidateswhosewritingspeedispermanentlyaffected)?

Areyouachild/familymemberofthosewhodiedin1984riots?

: NO

AreyouapersondomiciledintheStateofJammu&Kashmirduring
theperiod111980to31121989?

: NO

Religiontowhichyoubelong

: Hindu

DoyoubelongtoReligiousMinorityCommunity?

: NO

AreyouanExServiceman:?

: NO

AreyouaDisabledExServiceman(DISXS)?

Actualservicerenderedindefenceserviceswhichmaybecountedfor
qualifyingasanExserviceman(InMonths)

Dateofrelieffromdefenceservices

HaveyoujoinedaGovernmentjobonthecivilsideafteravailingofthe
benefitsgivenasanexserviceman?

AreyouaDependentofServicemankilledinAction(DXS)?

: NO

AreyouamatriculateExServicemencandidate,whohasobtainedthe
IndianArmySpecialCertificateofEducationorcorresponding
CertificateintheNavyortheAirForceafterhavingcompletednotless
than15yearsofserviceinArmedForcesoftheUnionason
12.09.2016?

PercentageofMarks

Areyouseekingrelaxationunderwidow/divorcedwomen/women
judiciallySeparatedfromtheirhusbandsandwhoarenotremarried?

: NO

WhetherRegularEmployeesoftheUnionCarbideFactory,Bhopal,
retrenchedfromservice(applicabletoMadhyaPradeshstateonly)?

: NO

HaveyouappliedfortheCWEforClericalCadreheldinNovember/
December2011?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldinDecember
2012?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldinDecember
2013?

: NO

RegistrationNo.

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CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)ApplicationFormPrint

HaveyouappliedfortheCWEforClericalCadreheldinDecember
2014?

: NO

RegistrationNo.

HaveyouappliedfortheCWEforClericalCadreheldinDecember
2015?

: YES

RegistrationNo.

: 1421404138

Nationality/Citizenship

: Indian

DoyouholdAadharCard?

: NO

AadharCardNo.

VacanciesofState/UTyouareapplyingfor

: UttarPradesh

Statecode

: 44

CentreofExamination

: Allahabad

ApplicationFee/Intimationcharges
Amount

: 600.00

PaymentStatus

: PAID

ReferenceID

: GSBI4744718584

TransactionDate

: 11092016

PersonalDetails
DateofBirth

: 04011993

Agecompletedason01.08.2016

: 23

Gender

: MALE

MaritalStatus

: Unmarried

Father'sName

: ARVINDKUMARPANDEY

Mother'sName

: MANSHAPANDEY

Spouse'sName

AddressforCorrespondence

: HOUSENO770B

Address2

: BHOOGOLPRESS
COMPOUND

Address3

: MEERAPUR

District

: ALLAHABAD

State

: UTTARPRADESH

Pincode

: 211003

Permanentaddress

: HOUSENO770B

Address2

: BHOOGOLPRESS
COMPOUND

Address3

: MEERAPUR

District

: ALLAHABAD

State

: UTTARPRADESH

Pincode

: 211003

ContactDetails
MobileNo

: +919717994265

AlternativeNumber
(MobileNo/LandlineNo)

EmailID

: shubhsaurab@gmail.com

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CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)ApplicationFormPrint

EducationalQualification(ason12.09.2016)
ExamPassed

Degree

Subject/Stream

Dateof
Passing

%ofMarks

Class/Grade

Graduation/Equivalent

B.Tech.

Engineering

28062014

70.48

FirstClass

DoyouhaveOperatingandworking
knowledgeincomputersystems:?

: YES

DetailsofComputerKnowledge:

: StudiedinHighSchool/College/Institute

: ComputerasaSubject

OtherDetails
WhetherdesirousoftakingPreExamTraining(Only :
forSC/ST/ReligiousMinorityCommunities/Ex
Servicemen/DISXS/DXS/PWD)
IfYes,CentreforTraining

OrganisationPreference

OrganisationinorderofPreferences

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

Whetheranyprosecution/detention/
fine/conviction/sentenceagainstyouhasbeen
awardedbyanycourtoflawforanyoffence?

Ifyes,particularsofthesame

NO

OtherDetails:

LanguagesKnown

Read

Write

Speak

HINDI

YES

YES

YES

ENGLISH

YES

YES

YES

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

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Date:11092016

CommonRecruitmentProcessforRecruitmentofClericalcadre(CWEClerksVI)ApplicationFormPrint

SignatureofApplicant

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