You are on page 1of 4

(Scheduled Commercial Bank)

To:
GENERAL MANAGER,
The Ratnakar Bank Ltd;
Administrative Office, PLEASE AFFIX
YOUR RECENT
‘Mahaveer ’179/E ward, PASSPORT SIZE
Shri Shahu Market Yard, PHOTOGRAPH AND
Kolhapur SIGN ACROSS

APPLICATION FOR THE POST OF – 1) CUSTOMER SERVICE REPRESENTATIVE (CSR)


2) FIELD SUPERVISOR

1. FULL NAME IN BLOCK LETTERS: (Leave one space blank between two parts of your name)
Mr. /Ms. (First name / Middle name / Surname )

2. ADDRESS FOR CORRESPONDENCE:

* P O S T O F F I C E
* P I N C O D E
* D I S T R I C T
* S T A T E
* Mandatory fields and should invariably be filled up.

3. POST APPLIED FOR : CUSTOMER SERVICE REPRESENTATIVE (CSR)


Indicate post applied for by 
mark in appropriate box
: FIELD OFFICER

SC ST GEN
4. (i) CATEGORY TO WHICH YOU BELONG :
Indicate by  mark in appropriate box
(Please enclose photocopy of certificate in case of SC/ST Certificate should be in the
prescribed format meant for Central Government posts and should have been issued on or
after 01.04.2007).

5. DATE OF BIRTH: DD MM YYYY

AGE (As on 31.10.2010): ___________ Years

Relaxation in Age (if claimed): No. of Years Under category : __________


[Please refer to Notification as regards your eligibility for claiming relaxation in Age]
6. YOUR CONTACT NO.:
1
STD Code No. Telephone No. Mobile No.

E- Mail Address

7. INDICATE BY  MARK IN APPROPRIATE BOX:

(i) GENDER: MALE F FEMALE (ii) BLOOD GROUP : _______

(iii): MARITAL STATUS:

SINGLE MARRIED WIDOW/WIDOWER DIVORCEE

8. In case of SC/ST Candidate

(i) Name of the Caste/Tribe/Class : __________

(ii) Name of the state to which you belong ____________

9. FATHER’S NAME:

10. HUSBAND’S NAME (in the case of married women):

11. Whether Spouse is employed (in the case of those married)? YES NO
If yes, Name of the Employer :

Post held :

Nature of post :

12. NATIONALITY ___________________ RELIGION ____________________

13. PLACE OF BIRTH: Place _________________ Dist. ______________State __________

14. PERMANENT ADDRESS:

P O S T O F F I C E
P I N C O D E
D I S T R I C T
S T A T E

15. HOME TOWN/VILLAGE: _________________ DISTRICT: _________________ STATE: ___________

16. Are you suffering from any major Health problems? YES NO
If yes, give details

2
17. EDUCATIONAL / PROFESSIONAL QUALIFICATIONS:

Details of Qualifying Examination passed as per the eligibility criteria prescribed in the Notification If
all the information in the box is not provided the application will be rejected.

Name of Subjects Name of Class/ Date/Month/Ye % of


Particulars
the Degree Studied University Division ar of passing Marks
Graduation

Post Graduation

Any other professional qualification that may be specified.

Note: Percentage of marks secured in aggregate shall be rounded off to the nearest 2 decimals.

18. PARTICULARS OF COMPUTER QUALIFICATION

Name of the
Name of the Computer Languages/ Duration of the Month & Year Class/
Degree/Diploma/
Institute Programmes/Applications Course of passing Divn.
Course

19. PARTICULARS OF POST-QUALIFICATION BANKING EXPERIENCE.


(As on 31.10.2010)

Name of Employer & Length of Nature of Remarks


Designation Period of service
Nature of activities Service duties (Reason for
& Scale
carried out by them From To Years months performed leaving service)

(If space is not sufficient please attach separate sheet)

20. Languages known: (Indicate by  mark in appropriate box) (Mention the names of languages known
in the appropriate column)

Sl. No. Language Read Write Speak


1
2
3
4

3
DECLARATION

I hereby declare that all the statements made in this application are true, complete and correct to the
best of my knowledge and belief. 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 notification, my candidature / appointment is liable to be cancelled/terminated. I am willing to
serve anywhere in India. I agree that Bank has right to transfer me to any part of the country at its
discretion.

Place :_____________ Date :__________ __________________


Signature of applicant

/opt/scribd/conversion/tmp/scratch2447/45095709.doc.1-4

You might also like