12/13/2019 CBSE Form 2019

Applicant Details

Personal Details
Application Sequence No
CBSE1488349

Candidate's Full Name

ROHIT SINGH

Father's Name Mother's Name

BIPIN KUMAR SINGH INDU DEVI

Marital Status Nationality

Unmarried Indian

Post Applied Details

Post Applied Post Code
JUNIOR ASSISTANT 8/19

Center Choice 1 Center Choice 2

Dehradun Roorkee

Center Choice 3 Center Choice 4

Haldwani Moradabad

Center Choice 5 Category

Ambala UR

Gender Date of Birth (DD-MM-YYYY) same as Matriculation/

Secondary Certificate
Male

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12/13/2019 CBSE Form 2019

13/Jun/1999

Age as on 16.12.2019
20 Years 6 Months 3 Days

Are you Physically Handicapped (PH) (degree of

disability 40% or above)?
No

Are you an Ex-Service man?

No

Are you Departmental candidate?

No

Is there any relation is an employee of the board?

No

Contact Details
Mobile Number
7983976387 Email ID
rsrohitsingh9761@gmail.com

Present Address

Address Line 1
A-48 CISF COMPLEX GARHI CANTT

State
Uttarakhand

Country
India

City District
DEHRADUN Dehradun

Police Station Pin Code

GARHI CANTT 248003

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12/13/2019 CBSE Form 2019

Permanent Address

Address Line 1
BELWASA HUSSAINGANJ

State
Bihar

Country
India

City District
SIWAN Siwan

Police Station Pin Code

AANDAR 841237

Matriculation (10th) Details

Name of the Board/Council/University

cbse

Name of the Institute/School

Kendriya Vidyalaya New Tehri Town

Subject

Hindi,English,Maths,Science,Social Science

Year Of Passing Percentage of Marks

2015 60.8

Degree/Certificate/Mark Sheet Serial number

1211501

Intermediate (12th) Details

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12/13/2019 CBSE Form 2019

Name of the Board/Council/University

cbse

Name of the Institute/School

Kendriya Vidyalaya New Tehri Town

Subject
Physics,Chemistry,Maths,English,Hindi,Physical Education

Year Of Passing Percentage of Marks

2017 54.6

Degree/Certificate/Mark Sheet Serial number

1197522

Essential Experience Details

Skill Test Language

English

Payment Details
Amount to be Paid Payment Status
800 Successful

Payment Transaction No.

RSM28300333794

Candidate Documents/Images Upload Details

Photo

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12/13/2019 CBSE Form 2019

Signature

I hereby declare that I have added my passport photograph

Declaration

I hereby, solemnly declare that information provided by me in the form is true to the best of my
knowledge and belief and that I have not concealed any information affecting my
eligibility/candidature to apply.I understand that my candidature is subject to the conditions laid
down in the adverisement. I further declare that I am not involved in any criminal case and/or no
such case is pending against me in any court of law.In case any of the above information is found
false or wrong my candidature shall be cancelled.

Further, even if it is detected at a later stage that I have furnished any false information/ particulars
with regard to my qualification, category/cast and experience in the Application Form or in any
document and/or mispresented/suppressed any material fact in the application form, for securing
appointment in the Board, my service will be terminated forthwith during probation period or even
after confirmation of the service in the Board.

Version 13.07.01

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