Application of Job: PC [PC(LOG)],SSC [SSC(EDU)] - 01/2019

Application No: PGG191M003659 Application Date: 23/01/2018

PRIORITY

1. PC [PC(LOG)] 01/2019

PERSONAL PARTICULARS

Name: SANDIP KUMAR

Father's/Mother's Name: BHOLA KUSHWAHA
Guardian's Name: BHOLA KUSHWAHA
A BLACK MOLE ON
Identification Mark 1:
SOLDER
Identification Mark 2: ---------
Nationality: INDIAN
Aadhaar/Enrolment No.: 312761493542
Central/State Govt. Issued EEYPK2080A
Photo ID:
Date of Birth: 20/03/1995

EDUCATION PARTICULARS

Details of B.E Qualification

Details of Qualification: B.E Stream: CIVIL Qualification Type: REGULAR

Cumulative Grade Point Average(CGPA): ( 7.11 * 10 ) / 1 Obtained Percentage: 71.10
Year of Passing: 2016
I E S COLLEGE
OF
University Name: RGPV BHOPAL College Name: TECHONOLOGY
AND
MANAGEMENT
MADHYA
College State: College District: BHOPAL
PRADESH

Details of 12th Qualification

 Percentage based 59.33%
Subjects Total Marks Obtained Marks
on PCM marks:
Physics 100 68

Chemistry 100 60

Maths 100 50

12th English Marks 100 65

10th English Marks 100 64

Serial no. of Marksheet: 1762065

Uttar Pradesh
UTTAR Board Conducted Madhyamik
State Conducted Exam:
PRADESH Exam: Shiksha
Parishad

Details of 10th Qualification

Uttar Pradesh
UTTAR Board Conducted Madhyamik Serial no. of
State Conducted Exam: 4072801
PRADESH Exam: Shiksha Marksheet:
Parishad

MILITARY RECORD

Have you ever been enrolled in Armed Forces before?: NO

Have you attended any Services Selection Board (SSB)
NO
before?:
Have you been discharged from Armed forces before?: NO

COMMUNICATION PARTICULARS

Details of Permanent Address

KANURA JURA MANRAKHAN

Address 1: Address 2: KANURA JURA MANRAKHAN KUSHINAGER
KUSHINAGER
State: UTTAR PRADESH District: KUSHI NAGAR Pincode: 274401
Phone No.: --------- Mobile No.: 7800323487
Email id: kushsandip143@gmail.com Alternate Email id: ---------

Details of Correspondence Address

Same as Permanent Address

Alternate Mobile Number: ---------

A. I hereby declare that I am unmarried, governed by nationality condition as laid down by the Government of Indian and
have never been debarred from appearing at any examination. I have never been arrested/ prosecuted and convicted by a
criminal court or involved in any other case registered by the Police.
B. I hereby, solemnly declare that all the statements made in the above application are true and correct to the best of my
knowledge and belief.
C. I fully understand that in the event of my information being found false or incorrect, appropriate action can be taken
against me.
D. Eligibility criteria will be verified on reporting at the selection centres. I found ineligible, I understand that criminal
proceedings can be initiated against me for fraudulent entry and falsification of Government of Indian documents. I also
accept that no TA/ DA will be admissible to me in such cases.