BANK OF BARODA RECRUITMENT OF CLERICAL STAFF PROJECT 2009

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Leona Thomas
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1 BANK OF BARODA RECRUITMENT OF CLERICAL STAFF PROJECT 2009 APPLICATION FORM FOR THE RECRUITMENT OF CLERICAL STAFF To Bank of Baroda, Recruitment of Clerks-Project 2009, Post Box No.341, Bank of Baroda Port Blair, Andaman & Nicobar Islands, Pin Code Please paste a passport size photograph, duly signed across With reference to your advertisement on Bank s Website/ The Daily Telegrams dated I submit my application in prescribed format. Full Name : Address for Correspondence: State: Pin Code: State applied For Post applied State Code : : Port Blair : Clerks Category : If person with disability : Type of Disability : % Disability : Date of Birth (As per School Leaving Certificate SSLC /SSC): (Age completed as on ):

2 Details of Non Refundable Application Fee / Postal Charges: Name of Issuing Bank : Place of Issue : Date of Issue : Amount : Demand Draft No. : MICR No. Next 6 digits: Transaction Code : S.T.D. Code: Mobile No. Phone No. : id. : Sex: Nationality: Total Period of Service as Ex-servicemen in Months: Are you Ex-Serviceman : Date of Discharge : Rank of Present / Last held: a) Acting : Acting w.e.f b) Substantive: Acting Substantive w.e.f. Are you seeking age relaxation under The Children / family members of those who died in the 1984 riots : Are you ordinarily been domiciled in Kashmir : Whether you belong to Religious Minority Community: Religion: Caste / Tribe / Class : State to which you belong: Marital States :

3 Divorced judicially : Separated : Pre Exam Training : Father s Name : Husband s Name : Permanent Address: State : Pin Code: Qualification Details: Course Name of Subject / Month/Year %of Class University Stream of Passing Marks obtained Passed 10 th Std 12 th Std Graduation Post Graduation Other

4 Level of Computer Literacy: Particulars of Post qualification work experience: Organization Served Designation and rank, if any Period of Service Nature From (dd/mm/yy) To (dd/mm/yy) of Duties performed Reason for leaving services Year(s) of experience

5 Languages Known : Language Read Write Speak Hindi English Before submitting the application, please check that you have correctly mentioned: 01. The State and Centre where you wish to appear for the test. 02. Category / sub-category and have enclosed copies of necessary certificates for SC/ST/OBC/PWD. 03. Details regarding fees (Demand Draft) and DD enclosed. 04. Address for correspondence. 05. Details for claiming relaxation in age and you have enclosed the relevant certificates. 06. Degree certificate indicating percentage of marks. DECLARATION I hereby declare that the 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 false or incorrect and not satisfying the eligibility criteria according to the requirements of the relative advertisement my candidature / appointment for the said post is liable to be cancelled / terminated at any stage and if appointed my services are liable to be terminated. I am willing to serve anywhere in India. I agree that the Bank has the right to post me to any part of the country at its discretion. 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 Port Blair and Courts / Tribunal / Forums at Port Blair. I undertake to abide by all the terms and conditions mentioned in the advertisement displayed on Bank s Website dated Place : Date : Signature of the Candidate Name : Note: This application should be signed by the candidate and sent along with 1. The application fees in the form of DD/BC of Rs.200/- (Rs.50/- for SC/ST/PWD candidates) favoring Bank of Baroda Recruitment of Clerical Staff Project 2009 Payable at Port Blair. Please write your name & date of birth on the reverse of the demand draft. 2. Copies of required certificates / testimonials. 3. Photograph pasted in the given place.

6 The application should reach the given address by The application posted from abroad and far flung areas (refer clause 2 of detailed advertisement) will be accepted till provided that the DD is dated on or after 12/12/2009 but on before The applicant must retain the photo copy of the application form for further reference. For Bank s Use Only: Registration No Allotted by Branch:

ANNEXURE-III (TO BE POSTED ON BANK S WEBSITE)

ANNEXURE-III (TO BE POSTED ON BANK S WEBSITE) Central Bank of India Samajik Utthan Avam Prashikshan Sansthan (CBI-SUAPS) (A Society/ Trust Sponsored by Central Bank of India) Engagement of Office Assistant