SOCIETY FOR ELECTRONIC TRANSACTIONS AND SECURITY [SETS]

MGR Knowledge City, CIT Campus, Taramani,

Chennai – 600 113. India.
Passport
APPLICATION FORM Size
Photograph
1. Advertisement No : SETS/Chn/Rec/2018-19/01
2. Post applied for :__________________________________________
3. Name in full (in block letters) :__________________________________________
4. Father’s/ Spouse’s name :__________________________________________
5. i) Date of Birth :__________________________________________
ii) Age as on closing date :__________________________________________
6. Nationality :__________________________________________
7. Religion :__________________________________________
8. Category (SC/ST/OBC/PH/General) :__________________________________________
9. Address for correspondence(in block letters) :__________________________________________
__________________________________________
__________________________________________
__________________________________________
Contact Telephone No. / Mobile No. :__________________________________________
E-mail ID :__________________________________________
10. Permanent address :__________________________________________
__________________________________________
__________________________________________
11. Current Position with organisation details :__________________________________________
(write NA if not applicable) __________________________________________
12. Educational Qualification (in chronological order from 10th standard onwards):
SI. Degree/Certificate Year of % of Marks University / Subject Remarks
No. Passing obtained or Institute specialization (if any)
CGPA

___________________________________________________________________________________
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13. Employment (in chronological order starting with the first job):
SI. Period Name of Position Salary drawn Jobs / Duties
No. From To Organization held with scale of pay handled
and grade pay

14. Details of research work / experience :______________________________________________

_______________________________________________
15. Thesis/Dissertation Topic :______________________________________________
______________________________________________
16. Specialization with reference to
experience desired for the post :______________________________________________
______________________________________________
17. Honors / Awards received if any :______________________________________________
______________________________________________
18. Any other information you wish to furnish :______________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

19. Application Fee Details:

Name of the Bank and Branch

NEFT Reference / DD No.

Date of Remittance / DD Date

Amount (Rs.)

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20. Reference (Two)
1 2
Name
Designation
Address

Mobile No.
Email ID

21. Declaration:

I certify that the information furnished above are correct and complete to the best of my
knowledge and belief and nothing has been concealed / distorted. If at any time I am found to have
concealed/distorted any material/information, my appointment shall be liable to be summarily
terminated without notice/compensation.

(Name and Signature of the Applicant)

Date :
Place:

List of Documents attached:

1. __________________________________________________________________
2. __________________________________________________________________
3. __________________________________________________________________
4. __________________________________________________________________
5. __________________________________________________________________
6. __________________________________________________________________
7. __________________________________________________________________

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