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Vananchal Gramin Bank Application for Recruitment of Officer JMG Scale- I & Office Assistant (Multipurpose) in Vananchal Gramin

Bank APPLICATION PRINT-OUT NEED NOT BE SENT TO THE BANK Last Modified On : -No.Of Times Modified : 0 5039 Registration No. : Post : Post Code : Full Name : Category : Person With Disability : Type of Disability : Percentage of Disability : Do you intend to use the services of a scribe : 11201 Officer Scale-I-Group "A" 01 AVISHEK KUMAR GENERAL No ----

Whether you belong to No Religious Minority Community : Religion to which you belong: Others: Domiciled in Kashmir Division: Ex-Serviceman : Total Period of Service : (in Months) Disabled Ex-Serviceman (DISXS) : Dependent Ex-Serviceman (DXS) : Seeking relaxation under widow/ divorced women/ women judicially Separated from their husbands and who are not re-married. Domiclie of Jharkhand : Nationality : Centre of Examination : Centre code : --No No -No No No

No Indian Dumka 11

Application Fee/ Postal Charges Details :

Payment In Transaction Id.: Branch Name : Branch Code : Deposit Date : Personal Details : Date of Birth : Gender : Husband's Name / Father's Name : Address for Correspondence : District : State : Permanent Address : District State : Contact Details: Phone No : Email ID :

State Bank of India 15133844 CLW LOCO BRANCH 10219 18/07/2011 Amount : 400

09/06/1986 Male SAROJ KUMAR STREET NO 63 QRS NO 4B CHITTARANJAN BURDWAN West Bengal STREET NO 63 QRS NO 4B CHITTARANJAN BURDWAN West Bengal

Age completed as on 31.03.2011 : Marital Status Mother's Name :

24 Unmarried RENUKA SINHA

Pin :

713331

Pin :

713331

0341-2525803 kumar.avishek07@gmail.com

Mobile No :

8967073281

Qualification Details(as on 31.03.2011): Exams Passed Name of the Course / Degree Others Year Of Passing % of Marks Class / Grade

Graduation Post Graduation Professional Qualification Others Knowledge of Computers Skill : Details of computer Knowledge :

2010

61.72

First Class

Yes JAVA PROGRAMMING

Post Qualification work experience details (Start from present Employer) : Name of the Employer Designation Period of Service From-To Total Period of Work Experience (in months) : -Nature of duties performed Reason for Leaving Length of Service (YY/MM)

Knowledge of the local language of the State / Union Territory for which he / she is applying

Languages Known ENGLISH HINDI BENGALI

Read Yes Yes No

Write Yes Yes No

Speak Yes Yes Yes

Pre-Examination Training : Centre for Pre-Examination Training : DECLARATION:

No --

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 Jharkhand and courts/ Tribunal/ forums at Jharkhand 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: 18/07/2011 Signature of Applicant: Name :AVISHEK KUMAR 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.