6/27/2018

Application for ( III ) BOTH W.B.F.S & W.B.S.F.S - WEST BENGAL FOREST SERVICE & WEST BENGAL SUB-ORDINATE FOREST SERVICE EXAMINATION,
2018 (Advt No.14/2018)

REGISTRATION NO: PSCWB00629461127 PAYMENT ID: CPSC6294610514A

Enrolment No: PSC00286737

Candidate Name: PRABAL DEY
Father's Name: PINAK PANI DEY
Mother's Name: ANITA DEY
Place of Birth: COOCH BEHAR
Do you have ability to read, write and YES
speak in Bengali:
Whether you are a Nepali Speaking NO
person:
State your mother tongue: BENGALI
Do you belong to S.T.Community / Race NO
such as Nepali, Garhwali, Gorkha?:
Date of Birth: 16. January .1989

Sex MALE Meritorious Sportsperson: NO

Height (cm.): 170
Chest girth (after full expiration)(cm.) : 90
Chest girth (after full expansion)(cm.): 100
Nationality Indian
Category General

Address For Correspondence Permanent Address

Address : C O PROLOY KR MITRA Address : C O PROLOY KR MITRA
BANGCHATRA RD NEAR RLY GATE BANGCHATRA RD NEAR RLY GATE
P O GURIAHATI DIST COOCH BEHAR P O GURIAHATI DIST COOCH BEHAR
State: West Bengal State : West Bengal
District : Cooch Behar District : Cooch Behar
Pin: 736170 Pin: 736170
Mobile No. 9051985002 Mobile No. 9051985002

Academic Qualifications (Madhyamik or equivalent and onwards)

Examination Examination Year of Name of Board/Council/University Subjects Taken Division/Class/Grade Marks % Remarks
Name Passing
Class 10th or MADHYAMIK BENG ENG HISTORY
2005 WBBSE 1ST 83.38
equivalent PARIKSHA GEOGRAPHY PSC LSC MATH
HIGHER
Class 12th or BENG ENG PHYSICS
equivalent SECONDARY 2007 WBCHSE CHEMISTRY MATH 1ST 71
EXAMINATION
Graduation B TECH IN
(Bachelor ELECTRICAL 2012 WBUT ELECTRICAL ENGINEERING 1ST 78.40
Degree) ENGINEERING

Have you at any time been NO

employed ?

Center Preference
Preference Siliguri

Optional Paper
Paper 1 Electrical Engineering
Paper 2 Environmental Science

I solemnly declare that :

a) I am eligible to apply for the examination as per the notification.
b) All statements made in this application are true, complete and correct.
c) Original documents will be produced on demand.
d) I agree to take this examination on the condition that the Commission may cancel my candidature if at any stage I am
found ineligible.

I have obtained all my certificates (Qualification, Disability Certificate and/or Caste) within the date of submission of my
application.
I have informed the Head of my Office or Department in writing that I am appling for this examination (Please click the box if you are in service of Govt. or Local or Statutory Body).
I agree that all the information provided here, are correct according to my knowledge
PLEASE REVIEW THE ABOVE DETAILS CAREFULLY FOR ANY ERRORS BEFORE CONFIRMING SUBMISSION.

YOU WILL NOT BE ABLE TO MAKE ANY CHANGE AFTER CONFIRMATION OF SUBMISSION
THE FORM WOULD BE CONSIDERED SUCCESSFULLY SUBMITTED ONLY AFTER PAYMENT OF EXAMINATION FEE ( IF APPLICABLE)
PLEASE DOWNLOAD YOUR ADMIT CARD BEFORE EXAMINATION

Date : 27-06-2018

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6/27/2018

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