A

APPLICATION FOR THE RECRUITMENT OF TALENTED SPORTSPERSONS

Affix a recent Passport-

size photograph and
sign across the bottom
portion of the photograph
(Please hold with you
three copies ofsame
photograph for subsequent
use)

* Application should be on A4 size (210 x 297 mm) paper only.

With reference to your Advertisement dated ……………… I submit my

application in the prescribed format.

1. Name (in BLOCK LETTERS) Mr/Mrs/Ms

2. Sex : Male Female

3. (a) Address for Correspondence

Correspondence Address (with Pin Code) Permanent Address (with Pin Code)

(Name and Address should be filled using CAPITAL LETTERS IN ENGLISH ONLY)

(b) Email id, if any :

(c) Mobile No.

(d) Phone No:

4. Sports discipline for which applied -----------------------------------------

5. Post Applied :
Officer Clerks

6. Indicate Category to which you belong by marking ‘ ’ in the appropriate box

SC ST OBC GEN

(a) In case of SC/ST/OBC candidates

i) Name of the Caste ……………………………..

ii) Name of the State to which you belong ……………………………..

7. Date of Birth (as per SSLC/SSC) ………………………………………

Age (as on 01.07.2010) Years Months

8. Particulars of Demand Draft/Banker’s Pay Order

Demand Draft/
Issuing Bank/ Drawee Bank/ Date of Amount
Banker’s Pay
Branch Branch Issue (Rs.)
Order No.

(Non-Refundable Fee including postal charges)

9. Nationality ……………………………...

10. Place of Birth:………… ……. .Town ……………... District ……………. State………………

11. Father’s Name ………………………………………………………………………

12. a) Educational and Professional Qualifications (as on the date of application,

Matriculation / SSLC onwards to be supported by attested copies of the certificates. Do
not enclose originals.)

Examination Name of the Subjects Month & No. of Percentage

passed Institution/ University/ Studied Year of attempts of marks
Place Passing obtained
13. Particulars of Sports qualification (as on the date of application to be supported by
attested copies of the certificates. Do not enclose originals)

Name of the event Level of representation Year of Position Remarks

(District / State / competition awarded
National / International)

14. I belong to SC/ST/OBC category and I am enclosing an attested photo copy

of the prescribed certificate (Tick the appropriate Box).

Yes No

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 false or
incorrect or not satisfying any of the eligibility criteria according to the requirements of the relative
advertisement, my candidature/appointment is liable to be cancelled/ terminated at any stage. I am
willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part of the
country at its discretion. I hereby agree that any legal proceedings in respect of any matter(s) or
claim(s) or dispute(s) arising out of this application and/ or out of the said advertisement can be
instituted by me only at Chennai and the Courts/ Forums/ Tribunals at Chennai only shall have sole
and exclusive jurisdiction to try the case/ dispute. I undertake to abide by all the terms and
conditions mentioned in the advertisement given by the Bank.

PLACE:

DATE :
SIGNATURE OF THE CANDIDATE