08/12/2016

ManipalSchoolofBankingPGDBFCourse201617

IDBIBankLtd.
ManipalSchoolofBankingPGDBFCourse201617

RegistrationNumber

: 133183182

FullName

: PritamJyotiChangkakoti

Category

: GENERAL

AreyouaPersonwithDisability

: NO

TypeofDisability

Percentageofdisability

Areyousufferingfromcerebralpalsyandyourwritingspeedisaffected

IfYes,Doyouneedcompensatorytimeatthetimeofexamination?

Whetheryourdominant(Writing)handisaffected

IfYes,Doyouneedcompensatorytimeatthetimeofexamination?

Doyouintendtousetheservicesofascribe(applicableonlyforVHorOH
Candidates)?

Categorycode

: 10

Areyouachild/familymemberofthosewhodiedin1984riots?

: NO

AreyouapersondomiciledintheStateofJammu&Kashmirduringthe
period111980to31121989?

: NO

Religiontowhichyoubelong

: Hindu

DoyoubelongtoReligiousMinorityCommunity?

: NO

AreyouanExServicemen,CommissionedOfficersincludingEmergency
CommissionedOfficers(ECOs)/ShortServiceCommissionedOfficers
(SSCOs):?

: NO

Actualservicerenderedindefenceserviceswhichmaybecountedfor
qualifyingasanExserviceman(InMonths)

HaveyoujoinedaGovernmentjobonthecivilsideafteravailingofthe
benefitsgivenasanexserviceman?

Nationality/Citizenship

: Indian

DoyouholdAadhaarCard?

: NO

AadhaarCardNo.

Place(District)ofdomicile

: KAMRUP

Stateofdomicile

: ASSAM

State/UT/NCRforwhichthecentreofExaminationbelongs

: Assam

CentreofExamination

: Guwahati

ApplicationFee/Intimationcharges
Amount

: 700.00

PaymentStatus

: PAID

ReferenceID

: HSM34955342306

TransactionDate

: 08122016

PersonalDetails
DateofBirth

: 13021990

http://ibps.sifyitest.com/idbimsbnov16/registration_print.php?q=MWQ3NTM5ZmM4NTNlZTVjNDA2Y2EzNjMwOGQwNWU2YTR8MTMzMTgzMTgy

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ManipalSchoolofBankingPGDBFCourse201617

Agecompletedason01.10.2016

: 26

Gender

: MALE

MaritalStatus

: Unmarried

Father'sName

: BUBULCHANGKAKOTY

Mother'sName

: SARASWATIDEVI

Spouse'sName

AddressforCorrespondence

: KACHARIBASTIDISPUR
COLLEGEROAD

Address2

: OPPOSITESHIVMANDIR
HOUSENO92

Address3

: GANESHGURI

District

: KAMRUP

State

: ASSAM

Pincode

: 781005

Permanentaddress

: KACHARIBASTIDISPUR
COLLEGEROAD

Address2

: OPPOSITESHIVMANDIR
HOUSENO92

Address3

: GANESHGURI

District

: KAMRUP

State

: ASSAM

Pincode

: 781005

ContactDetails
MobileNo

: +917035890994

AlternativeNumber
(MobileNo/LandlineNo)

EmailID

: prit.feb13@gmail.com

EducationalQualification(ason01.10.2016)
Exam
Passed

Nameofthe
College

Nameofthe
University

Degree

Subject/Stream/Specialization

Dateof
Passing

%ofMarks

Class/
Grade

Graduation/
Equivalent
(passed)

COTTON
COLLEGE

GAUHATI
UNIVERSITY

B.Sc.

ECONOMICS

0407
2014

FirstClass

Academicyear

Semester MarksObtained

TotalMarks

Semester MarksObtained

TotalMarks

MarksObtained

TotalMarks

YearI

121

200

121.00

200

YearII

145

200

145.00

200

YearIII

358

600

358.00

600

YearIV

0.00

YearV

10

0.00

GrandTotal

624.00

1000

Total%

62.40

Doyouhaveproficiencyincomputers:?

: YES

DetailsofComputerKnowledge:

: MSexcelandword

OtherDetails:
http://ibps.sifyitest.com/idbimsbnov16/registration_print.php?q=MWQ3NTM5ZmM4NTNlZTVjNDA2Y2EzNjMwOGQwNWU2YTR8MTMzMTgzMTgy

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ManipalSchoolofBankingPGDBFCourse201617

WhetherdesirousoftakingPreExamTraining(Only
forSC/ST/OBC):

IfYes,CentreforTraining

Whetheranyprosecution/detention/fine/conviction/
sentenceagainstyouhasbeenawardedbyany
courtoflawforanyoffence?:

: NO

Ifyes,particularsofthesame:

LanguagesKnown

Read

Write

Speak

ENGLISH

YES

YES

YES

ASSAMESE

YES

YES

YES

HINDI

YES

NO

YES

Declaration:
IherebydeclarethatallthestatementsmadeinthisapplicationareTrue,CompleteandCorrecttothebestofmyknowledgeandbelief.I
understandthatintheeventofanyinformationbeingfounduntrueorincorrectatanystageorIamnotsatisfyinganyoftheeligibility
criteriastipulated,andalsoincaseofcreatinginfluence/unduepressureregardingrecruitmentshalltantamounttocancellationofmy
candidature.

Date:08122016

SignatureofApplicant

http://ibps.sifyitest.com/idbimsbnov16/registration_print.php?q=MWQ3NTM5ZmM4NTNlZTVjNDA2Y2EzNjMwOGQwNWU2YTR8MTMzMTgzMTgy

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