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ON-LINE APPLICATION FOR COMMON WRITTEN EXAM FOR CLERICAL CADRE

2703

Registration # : 2005343523

Full Name : EINA KAPOOR

Category : GENERAL

If Person with Disability : NO

Type of Disability : -

Percentage of Disability : -

Do you intend to use the services of a scribe

(only for VI & OC both hands affected by cerebral palsy) ? :NA

Whether you Chi ldren / fami ly members of those who d ied in 1984 riots? : NO

Whether you domiciled in Kashmir Division of the State of

J&K during the period 1-1-1980 to 31-12-1989? :NO

Whether you belong to Religious Minority Community ? : NO

Religion to which you belong : -

Are you an Ex-Serviceman ? : NO

Are you a disabled Ex-Serviceman (DISXS)? : NO

Are you a dependent of an Ex-Serviceman killed in action ? : NO

Have you passed in one of the following Armed Forces Examinations equivalent to

Civil Examination of HSc/Pre-University? :

IAF Education Test for Promotion to rank of Corporal : NO

Passing Out (Indian Navy) Examination conducted by Boys Training Establishment,

Visakhapatnam :NO

Are you a matriculate Ex-Servicemen candidate, who has obtained the Indian Army

Special Certificate of Education or corresponding Certificate in the Navy or the Air

Force after having completed not less than 15 years of service in Armed Forces of the

Union? :

NO

Are you seeking relaxation under widow / divorced women / women judicially

Separated from their husbands and who are no t re-married? :NO

Whether Regular Employees of the Union Carbide Factory, Bhopal, retrenched from

service (applicable to Madhya Pradesh state only)? :NO

Nationality : Indian

State/ UT which the Centre of Examination Belongs : New Delhi

State / UT Code : 35

Centre of Examination : New Delhi

Centre Code : 180

Application Fee / Intimation Charges details:

Payment Mode: CBS

Name Of Payee Bank : Bank of Baroda

Transaction No. : 26091150091712

Branch Name : RAJENDER NAGAR

DP Code / Branch Code No : 3040

Deposit Date : 26-09-2011

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Amount : 350

Personal Details :

Date of Birth : 10-08-1985

Age completed as on 01.08.2011 : 25

Gender : FEMALE

Husband's Name/Father's Name : MR. L.K. KAPOOR

Mother's Name : MRS. SUMAN KAPOOR

Address for Correspondence : H. NO. 170 SATYAM ENCLAVE

NEAR IME COLLEGE G. T. ROAD

SAHIBABAD

District GHAZIABAD

State : UTTAR PRADESH

Pin : 201005

Permanent Address : H. NO. 170 SATYAM ENCLAVE

NEAR IME COLLEGE G. T. ROAD

SAHIBABAD

District GHAZIABAD

State : UTTAR PRADESH

Pin : 201005

Contact Details : Email ID : eina.kapoor@gmail.com

Phone No : -

Mobile No : 9560199851

Qualification Details (as on 01.08.2011):

Exam Passed Subject /Stream Date of Passing % of Marks

Graduation/Equivalent : B COM 10-10-2007 44.00

Other Details :

Would You like to undergo Pre-Exam Training (SC/ST/Minority Community/ Ex-

Servicemen /PWD) :--

If Yes, Centre for Training : --

Languages Known Read Write Speak

EINGLISH YES YES YES

HINDI YES YES YES

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 untrue or incorrect at any stage or my not satisfying any of the eligibility criteria stipulated, my candidature is liable to be cancelled.

Place:

Date: 26-09-2011 Signature of Applican

Please retain your Registration No. and Password emailed to you carefully for further reference

NOTE: Please DO NOT SEND application printout to IBPS

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