Application Form

Application No: OL/2024/1222

Applicant and Program Details

Basic Details
24 MONTHS - HUMAN
Mode of Study ONLINE LEARNING Program RESOURCE
MANAGEMENT
Personal Details
Title MR. First Name PIYUSH Middle Name
Father / Husband
Last Name THAKUR PANKAJ KUMAR THAKUR Mother Name PUNITA DEVI
Name
Email Address THAKURPIYUSH36@GMAIL.COM Mobile Number +91-7544058300 Alternate Number
Date of Birth 12/08/1998 Gender MALE Mother Tongue HINDI
Nationality INDIAN Aadhaar Card Number 468120218061 Category GENERAL
Are You Currently Mention Your BROOKFIELD ASSET
Blood Group B+ YES
Employed Company Name MANAGEMENT
Total Year Of
Designation TALENT ACQUISITION SPECIALIST 3 Religion HINDUISM
Experience
How did you hear If you are already a
Citizenship Status INDIAN SEARCH ENGINES
about us? member of NLDES
Institute ID
Passport Details
Passport Number Country Place of Issue
Date of Issue Date of Expiry

Address Details
Address for Correspondence
Country INDIA State MAHARASHTRA District MUMBAI
711, KHATIJA TOWERS,
City MUMBAI Address Line 1 MALKANI ESTATE, Address Line 2
MALAD EAST
Is Permanent Address
Pincode 400097 Same As Address For NO
Correspondence?
Permanent Address
Country INDIA State BIHAR District MADHEPURA
WARD NO 10, NOHAR,
City Address Line 1 GWALPARA, Address Line 2
MADHEPURA, BIHAR
Pincode 852115

Educational Qualification Details

Academic Details
Xth Details

School Name Board Year of Passing Marking Scheme Obtained Percentage/CGPA

Xth JNV SAHARSA CENTRAL BOARD OF SECONDARY EDUCATION (CBSE) 2014 CGPA 9.8

After Xth
XIITH
Qualification
XIIth Details

School Name Board Year of Passing Result Status Marking Scheme Obtained Percentage/CGPA
SRI CHAITANYA TECHNO CENTRAL BOARD OF SECONDARY
XIIth 2016 DECLARED PERCENTAGE 75.6
SCHOOL EDUCATION (CBSE)

Diploma Details

Institution Name University Branch Year of Passing Result status Marking Scheme Obtained Percentage/CGPA
Diploma

Graduation Details
 Year of Obtained
Institute Name University Degree Result Status Marking Scheme
Passing Percentage/CGPA
VEER BAHADUR SINGH
SARVODAY GROUP OF
UG PURVANCHAL UNIVERSITY, BCOM 2020 DECLARED PERCENTAGE 75.2
INSTITUTIONS
UTTAR PRADESH

Post Graduate Details

Institution Name University Degree Year Of Passing Result Status Marking Scheme Obtained Percentage/CGPA
PG

Do You have Any

Other NO
Qualification?
Any Other Qualification

Institution Name University Degree Year Of Passing Obtained Percentage/CGPA

1
2
3

Upload Documents
Upload Files

Upload Your Recent

Upload Your Upload Your Xth
Passport Size YES
Signature : Certificate :
Photograph :

Upload Your
Upload Your XIIth Upload Your PG
YES Graduation YES NO
Certificate : Result :
Marksheets :

Upload Residential
Upload Your Aadhaar Upload Diploma
YES NO Proof (Aadhar Card / NO
Card : Certificate :
Passport) :

Identity Proof (Pan

Card / Aadhar Card / NO
Passport) :

Declaration
I certify that the
information
submitted by me
in support of this
application, is
true to the best of
knowledge and
belief. I
understand that in
the event of any
information being
PANKAJ KUMAR
found false or I AGREE Applicant Name PIYUSH THAKUR Parent Name
THAKUR
incorrect, my
admission is liable
to be rejected /
cancelled at any
stage of the
program. I
undertake to
abide by the
disciplinary rules
and regulations of
the institute.
Date 06/07/2024