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ON-LINE APPLICATION FOR RECRUITMENT OF CLERICAL CADRE

Last Modified On: 28-12-2011

No Of Times Modified: 2

16039
Registration # : 3000000265

Full Name :

Sarvaiya Yashesh Jagrutbhai

State/UT Applied for : Category : If Person with Disability : Type of Disability : Percentage of Disability :

Gujarat OBC NO -

Do you intend to use the services of a scribe (only for VI & OH candidates whose writing NA speed is affected by cerebral palsy) ? : Are you candidate who had ordinarily been domiciled in Kashmir Division of the State of J & K during the period 1-1-1980 to 31-12-1989 ? : Whether you belong to Religious Minority Community ? : Religion to which you belong : Are you an Ex-Serviceman ? : Are you Disabled Ex-Serviceman (DISXS) ? : Are you a Matriculate ? : Have you obtained the Indian Army Special Certificate of Education or corresponding certificate in the Navy or the Air Force, after having completed not less than 15 years of service in Armed Forces of the Union : Are you Dependent of an Ex-Serviceman killed in action (DXS)? : Are you seeking relaxation under widow /divorced women / women judicially Separated from their husbands and who are not re-married ? : Nationality / Citizenship : Centre of Examination : Centre Code : Application Fee / Intimation Charges details: Payment Mode: Amount : Personal Details : Date of Birth : Age completed as on 01.12.2011 : Gender : Husband's Name/Father's Name : Mother's Name : Address for Correspondence : 27-12-1989 21 MALE Sarvaiya Jagrutbhai Maganlal Sarvaiya Rekhaben Jagrutbhai B-12 Shantinath Appartment Near Golibar Temple Rupani Circle District State : Pin : Permanent Address : Bhavnagar GUJARAT 364001 B-12 Shantinath Appartment Near Golibar Temple Rupani Circle CBS 350.00 NO NO India Bhavnagar 12 NO NO NO NO

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District State : Pin : Contact Details : Email ID : Phone No : Mobile No : Qualification Details (as on 01.12.2011): Exam Passed SSC/Equivalent : HSC/ 12th(10+2) / Equivalent : Graduation/Equivalent : Other : Other Details : Would You like to undergo Pre-Exam Training (SC/ST/Minority Community/ XS / DXS / Dependents of XS) : If Yes Centre for Training : Languages Known English Hindi Gujarati Read YES YES YES --Write YES YES YES Speak YES YES YES Subject /Stream Gujarati Commerce Management CCA computer Date of Passing 10-03-2005 12-03-2007 16-04-2010 09-01-2010 % of Marks 77.71 60.86 75.43 92.75 y.sarvaiya9904@gmail.com 0278-2562682 9426149904 Bhavnagar GUJARAT 364001

DECLARATION:
I hereby declare that all 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 untrue or incorrect at any stage or my not satisfying any of the eligibility criteria according to the Central Recruitment & Promotion Department, my candidature is liable to cancelled. I am willing to serve anywhere in India including rural areas.

Place:

Date: 28-12-2011

Signature of Applicant

Please retain your Registration No. and Password emailed to you carefully for further reference NOTE: Please DO NOT SEND application printout to IBPS