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ON-LINE APPLICATION FOR RECRUITMENT OF CLERICAL STAFF (Clerks /
Stenographers)
3703
Registration # : 4000019986
Full Name : MAYANK CHHAJED
Have you applied for the post of Clerk under vacancies
advertised vide CRPD
advertisement CRPD/CR/2011-12/05 dated 27.12.2011? :NO
If yes, please specify Registration Number (You have the option
to apply for the post(s)
of Stenographer):
Post Applied for : Clerk
State/UT Applied for : Rajasthan
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 &
OH candidates whose writing
speed is affected by cerebral palsy) ? :NA
Are you candidate who had o rdinarily been 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 Disabled Ex-Serviceman (DXS) ? : NO
Are you a Matriculate ? :
Have you obtained the Indian Army Special Certificate of
Education
or corresponding certificate in the Navy or the Air Force, after
havingcompleted not less than 15 years of service in Armed Forces
of the Union :
Are you Dependent of an Ex-Serviceman killed in action ? :
NO
Are you seeking relaxation under widow /divorced women /
women
judicially Separated from their husbands and who are not
re-married ? :NO
Nationality / Citizenship : INDIAN
Centre of Examination : Jaipur
Centre Code : 67
Application Fee / Intimation Charges details:
Payment Mode: ONLINE
Amount : 350.00
Personal Details :
Date of Birth : 09-03-1989
Age completed as on 01.12.2011 : 22
Gender : MALE
Husband's Name/Father's Name : MANOHAR CHHAJED
Mother's Name : SUMITRA CHHAJED
Address for Correspondence : 3/204 NADI MOHALLA
NEAR BADE MANDIR
BHILWARA (RAJASTHAN)-311001
District BHILWARA
State : RAJASTHAN
Pin : 311001
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Permanent Address : 3/204 NADI MOHALLA
NEAR BADE MANDIR
BHILWARA (RAJASTHAN)-311001
District BHILWARA
State : RAJASTHAN
Pin : 311001
Contact Details :
Email ID : [email protected]
Phone No : 01482-239633
Mobile No : 9414372157
Qualification Details (as on 01.12.2011):
Exam Passed Subject /Stream Date of Passing % of Marks
SSC/Equivalent : GENERAL CBSE 26-05-2004 85.80
HSC/ 12th(10+2) / Equivalent : PCM CBSE 23-05-2006 67.60
Other Details :
Knowledge of Stenography : NO
Would You like to undergo Pre-Exam Training (SC/ST/Minority
Community/ XS /
DXS / Dependents of XS) :--
If Yes Centre for Training : --
Languages Known Read Write Speak
English YES YES YES
HINDI YES YES YES
DECLARATION:
I hereby dec lare 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 incorrec t at any stage or my not
satisfying any of the eligibility cr iteria according to the
Central Rec ruitment & Promotion Department, my candidature is
liable to cancelled. I
am willing to serve anywhere in India including rural areas.
Place:
Date: 06-03-2012 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 CRPD/ SBI
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