BRGB Bank

Application for Recruitment of Officers and Office Assistants in Baroda Rajasthan Gramin Bank
Online Application for Recruitment of Officers and Office Assistants in BRGB BANK - 2010
APPLICATION PRINT-OUT NEED NOT BE SENT TO THE BANK
30028
Registration No. : 19299
Post.: OFFICE ASSISTANTS (MULTIPURPOSE)-GROUP-B
Post Code: 03
Full Name : JITENDRA KUMAR
PAREEK
Category : GENERAL
Person With Disability : No
Type of Disability : -- Percentage of Disability : -
-
Do you intend to use the
services of a scribe :
No
Whether you belong to
Religious Minority
Community :
No
Religion to which you
belong:
Others: --
Domiciled in Kashmir
Division:
No
Ex-Serviceman : No
Total Period of Service :
(in Months)
Disabled Ex-Serviceman
(DISXS) :
No
Dependent Ex-
Serviceman (DXS) :
No
Seeking relaxation under
widow/ divorced women/
women judicially
Separated from their
husbands and who are not
re-married.
No
Domiclie of Rajasthan : Yes
Nationality : indian
Centre of Examination : Bhilwara Centre code : 12
Application Fee/ Postal Charges Details :
Transaction No : M362865
BOB Branch Name : bob chittorgarh
Branch Code : 0140
Deposit Date : 02/12/2010 Amount : 400
Personal Details :
Date of Birth : 31/10/1985 Age completed as on
01.11.2010 :
25
Gender : Male Marital Status : Single
Husband's Name /
Father's Name :
RADHESHYAM PAREEK Mother's Name : VISHNUKANTA PAREEK
Address for
Correspondence :
JITENDRA C/O P C
KUMAWAT,B-156,
ZINC NAGAR,KAPASAN
ROAD,
CHITTORGARH
District : CHITTORGARH
State : Rajasthan Pin : 312001
Permanent Address : JITENDRA C/O P C
KUMAWAT,B-156,
ZINC NAGAR,KAPASAN
ROAD,
CHITTORGARH
District CHITTORGARH
State : Rajasthan Pin : 312001
Contact Details:
Phone No : - Mobile No : 9950591345
Email ID : jitupareek31@gmail.com
Qualification Details(as on 01.11.2010) :
Exams Passed Subject /Stream Year Of Passing % of Marks
Graduation Science 2005 63.40
Post Graduation
Professional Qualification
:

Others
Knowledge of Computer : Yes
Post Qualification work experience details (Start from present Employer) :
Name of the
Employer
Designation Period of Service Length of Service
(YY/MM)
Nature of duties
performed
Reason for
Leaving
From-To
-
-
-
Whether Desirous of
taking Pre-Examination
Training :
No Centre for Pre-
Examination Training :
--
Languages Known Read Write Speak
Hindi Yes Yes Yes
english Yes Yes Yes
rajasthani Yes Yes Yes


DECLARATION:
I hereby certify that the above information furnished is correct to the best of my knowledge and belief. I have
not suppressed any material fact or factual information in the above statement. I am aware that in case I
have given wrong information or suppressed any material fact or factual information or I do not satisfy the
eligibility criteria according to the advertisement, then my candidature will be rejected/ service terminated
even after permanent employment without giving any notice or reasons thereof.
I hereby certify that I am satisfying the eligibility criteria for the post applied for in terms of advised criteria in
respect of age, caste, educational qualification etc.
I hereby agree that any legal proceeding in respect of any matter or claims or disputes arising out of
application or out of said advertisement can be instituted by me only at Ajmer and courts/ Tribunal/ forums at
Ajmer only, shall have sole and exclusive jurisdiction to any cause/ dispute. I undertake to abide by all the
terms and conditions in the advertisement given by the Bank.
Place:
Date: 10/12/2010
Signature of Applicant:
Name :JITENDRA KUMAR PAREEK
Note: Please retain your registration No. Password emailed to you and copy of printout carefully for further
reference. Please DO NOT SEND application print-out to the Bank.
Please retain your Registration No. and Password carefully for future reference.