itute of Banking ersonnel Selection 41172017 Common Recrukmment Process (CRP) for Recruitment of Probationry Officer Management Trainees in Paricipating Organizations: (CWE POMT-VI) Institute of Banking Personnel Selection Common Recruitment Process (CRP) for Recruitment of Probationary Officer/ Management Trainees in Participating Organizations- (CWE PO/MT-VI) Registration Number Full Name Category ‘Ave you a Person with Disability ‘Type of Disability Percentage of disability ‘Are you suffering rom cerebral palsy and your writing speed is afected + IFYes, Do you need compensatory time atthe time of examination? Whether your dominant (Writing) hand is affected IFYes, Do you need compensatory time atthe time of examination? Do you intend to use the services ofa scribe ? ‘Are you 8 child family member of those who died in 1984 riots? ‘Are you @ person domiciled inthe State of Jammu & Kashmir during the period 1-1-1980 to 31-12-1988? ‘Aco you an Ex-Servicoman :? ‘Actual service rendered in defence services which may be counted for {qualifying as an Ex-sarviceman (In Months) Date of relief from defence services Have you joined a Government ob on the civil side after availing ofthe benefits given as an ex-serviceman? Religion to which you belong o you belong to Religious Minority Community ? Whether serving in Govt’ quasi Govt/ Public Sector Undertakings {including Nationalised Banks & Financial Institutions)? Have you appeared for the CWE POIMTheld in year 2011 7 Registration No. Have you apps 36 for the CWE POIMT held in year 2012 ? Registration No. Have you apps 34 for the CWE POMT held in year 2013 ? Registaton No. Have you appeared for the CWE POIMTheld in year 2014 7 Registaton No. Have you appeared for he CWE POIMTheld in yoar 2015 ? Registration No. piops sits comlerppolouij18redistraon print. pop? OGY TMOZjexMWIOMWNKNm QSYZRIZjASNmRraNzGxY)REMTGIM Thwht2YON) 1 1471203646 1 SNEHAL DADARAO KAMBLE sc : NO : NO : NO : NO Hindu : NO : YES : YES : YES us41720°7 Commen Recrukment Process (CRP) for Recruitment of Probationsy OFicer Management Trainees in Paricipating Organization (CWE POMT-VI) Do you hold Aadhar Card ? ‘Aadhar Card No. Nationality /itzenship ‘State/UTINCR to which centre of exam belongs State code Cente of Examination Application Fee / Intimation charges Amount Payment Status Reference ID ‘Transaction Date Personal Details Date of Birth ‘Age completed as on 01.07.2016 Gender Marital Stats Father's Name Mothers Name ‘Spouse's Name ‘Address for Correspondence Address 2 Distret ‘State Pincode Permanent adaress Address 2 Distret State Pincode Contact Details Mobile No ‘Alternative Number (Mobile NofLandline No) Email iO Qualification Details(as on 13.08.2016) ptitps sits comlerppotoij18redistraon print. pop? OGYxYTMOZjexMWIOMWNKNm QSY2RIZjASNmRraNzGxY)RSMTGIM TRwM2YON) 2 YES + 876716333125 + Indian + Maharashtra at + Nagpur 100.00 : PAD 1 GsBi4650993972 +: 07-08.2016 5 02-10-1990 125 2 MALE + Unmarried + Dadarao kamble + lalta 1093 Ashirwad nagar Near dadasahed| + thakre school Opp Gold gym Nagpur Nagpur : MAHARASHTRA 2 440024 1093 Ashirwad nagar Near " dadasaheb + thakre school Opp Gold gym Nagpur + Nagpur 1 MAHARASHTRA 1 44002 491 g890646513 + sumiti23567@gmallcom 841720°7 Commen Recrukment Process (CRP) for Recruitment of Probationsy OFicer Management Trainees in Paricipating Organization (CWE POMT-VI) Exam Passed Dogr Graduation /Equivalont BE. Subject /Stroam Date of of Marks Passing Engineering 04-2012 64.00 Do you have Operating and working knowledge in computer systems 7 Details of Computer Knowledge: Other Details Whether desirous oftaking Pre-Exam —: NO Training (Applicable only for SCIST/ Minority Community) Yes Cente for Training Organisation Preference Yes ‘Studied in High Schoot/Collog Computer as.a Subject Organisation in order of Preferences 4 Punjab National Bank 2 Canara Bank 3 Bank of Baroda 4 Bank of Maharashtra 5 Bankof India 6 Central Bank of India 7 Union Bank of India 8 IDBIBank 9.Dena Bank 10 Unites Bank of India 11 Corporation Bank 42 Oriental Bank of Commerce 13 Indian Overseas Bank 14UCO Bank 46 Punjab & Sind Bank 16 Andhra Bank 17 Allahabad Bank 18 Vijaya Bank 419 Syndicate Bank 20 Indian Biank Whether any prosecuton/ detention! finelconvictonl sentence against you has been ‘awarded by any cour of law for any ofence? Iryes, particulars ofthe same Other Details : No Marathi Hindi English Yes ves ves ves ves ves Yes ves ves Declaration: I hereby declare thatall the statements made inthis application are True, Complete and Correct to the best of my knowledge and belie. psitps sits comierppoloij18redistraon print. pope OGY TMOZjcxMWIOMWNKNm QSY2RIZjASNmRraNzGx¥)REMTGSM TWh 2YON) a441720°7 Commen Recrukment Process (CRP) for Recruitment of Probationsy OFicer Management Trainees in Paricipating Organization (CWE POMT-VI) Understand thatin the eventof any information being found untrue or incorrect at any stage or | am not salisying any of the eligiblliy criteria stipulated, and also in case of creating influencelundue pressure ragarding recruitment shal tantamount to cancellation of ry candidature, a] Date: 07-08-2016 Signature of Applicant psitps sits comierppoloij18redistraon print. pope OGY TMOZjcxMWIOMWNKNm QSY2RIZjASNmRraNzGx¥)REMTGSM TWh 2YON) 48