Online Application Form

Post Details :

Advertisement No. * : 6/2013 Category No. * : 1 Name of Post * : Computer Operator

Personal Details (as per matriculation certificate) :

Candidate Name* : Deepak Singh
Father's/Husband's Name* : Mohan Lal Singh
Mother's Name* : Seema Singh
Date of Birth(dd/mm/yyyy)* : 08/12/1982
Age As On Eligibility Date.* : 31 Years 0 Months 16 Days

Mailing Address :


Address* :
H.No.1234 Sector-15
City : Panchkula
District* : Panchkula
State* : Haryana
Pin Code* : 134113

Other Details :

Have you passed Hindi/Sanskrit upto Matriculation * : Yes
Nationality* : Indian
Sex* : Male Female
Marital Status* : Un-Married Married
Widow Divorce Destitute Non
Are you domicile of Haryana* : Yes No
Category* : General SC BC SBC EBPG
ESM DESM DFF OSP No
Are you Physical Handicap of Haryana* : Yes No
Physical Handicap Sub-Category : Ortho LowVision Blind D & D
Note : The candidates belonging to ESM/DESM/DFF/OSP/PHC will be required to select both the coloumns i.e. Category as well as caste which
they belong.
Are you employed in Govt /Public Sector Undertaking* :
(If yes and you are in regular service then give details
and have to submit NOC from the Employer at the
time of interview)
Yes No
Contact Number* : 9876543210
Email* : deepaktest@gmail.com
Confirm/Re-Enter Email* : deepaktest@gmail.com
Visible identification mark on the body of the candidate* : Cut on right hand wrist
Select Bank Name for E-Challan* : SBP-State Bank of Patiala

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Education Qualification :
Examination
Stream(i.e.10th
/B.Sc/M.Sc/etc)
Board/ University Subject
Year Of
Passing
Marks
Obtained
Total
Marks
Marks
in %
Division
(1/2/3)
Matriculation * 10th CBSE Hindi, English, Maths, Science, Social Science 1998 289 500 57.80 2
Intermediate * 12th CBSE Hindi, English, Maths, Physics, Chemistry 2000 329 500 65.80 1
ITI/Vocational Year
Diploma Year
Graduation Year
Post Graduation Year
Other Year

Reason For Gap ( If Any) :

Experience Details :

Organization Name Designation From Date To Date Total Exp. Nature of Duties Salary Per Month
Test Company Pvt. Ltd. Tester 01/02/2006 30/08/2012 6 y 6 m 29 d Testing 25000
Add More Experience

Documents Available With You In Support Of Your Eligibility For This Post :

Matriculation Certificate with Marksheet copy Intermediate Certificate with Marksheet copy
Graduation Degree with all Marksheets copy Post Graduation Degree with all Marksheets copy
All Other Qualification Degree with all Marksheets copy Experience Certificate copy
Copy of Challan/E-Challan Co-curriculum Certificate copy
Note : All Document Must Be Issued Before Clossing Date of Advt.
Upload Photo & Signature :
If the Upload Photo / Signature is not loaded in appropriate place, your application is liable to get rejected
Allowed Photo Size - 20KB to 50 KB File Type : *.jpge, *.gif
Allowed Signature Size - 10KB to 20 KB File Type : *.jpge, *.gif
Upload Photograph* : Photo.jpg Choose File
Upload Signature* : Signature.jpg Choose File

Declaration : I hereby declare that :-
1. All statements made in this application form are true, complete and correct to the best of my knowledge and belief. In the event of
any information being found false or incorrect, or ineligibility being detected before or after the interview/appointment/selection, my
candidature may be cancelled and action can be taken against me.
2. I have read the provisions/instructions in advertisement of the Commission carefully and I hereby undertake to abide by them. I fulfill
all the conditions of eligiblity regarding age limits, educational qualifications etc, prescribed in the advertisement and other relevant
rules and instructions.
3. I have never been convicted by Criminal Court.

I agree.
Submit Cancel

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