Vous êtes sur la page 1sur 3

A

APPLICATION FOR THE RECRUITMENT OF TALENTED SPORTSPERSONS

Affix a recent Passport- size photograph and sign across the bottom

portion of the photograph

(Please hold

with you

three copies ofsame photograph for subsequent use)

* Application should be on A4 size (210 x 297 mm) paper only.

With reference to your Advertisement dated ……………… I submit my application in the prescribed format.

1. Name (in BLOCK LETTERS)

Mr/Mrs/Ms

2. Sex : Male Female
2. Sex
:
Male
Female

3. (a) Address for Correspondence

Correspondence Address (with Pin Code)

Correspondence Address (with Pin Code) Permanent Address (with Pin Code)

Permanent Address (with Pin Code)

Correspondence Address (with Pin Code) Permanent Address (with Pin Code)

(Name and Address should be filled using CAPITAL LETTERS IN ENGLISH ONLY)

(b)

Email id, if any

:

(c)

Mobile No.

(d)

Phone No:

4.

5.

Sports discipline for which applied

Post Applied :

-----------------------------------------

Officer

Officer Clerks

Clerks

Officer Clerks

6.

Indicate Category to which you belong by marking

in the appropriate box

SC

ST

OBC

GEN

(a) In case of SC/ST/OBC candidates

i) Name of the Caste

……………………………

ii) Name of the State to which you belong ……………………………

7.

8.

Date of Birth (as per SSLC/SSC)

………………………………………

Age

(as on 01.07.2010)

Age (as on 01.07.2010) Years Months Particulars of Demand Draft/Banker ’s Pay

Years

Age (as on 01.07.2010) Years Months Particulars of Demand Draft/Banker ’s Pay Order

Months

Particulars of Demand Draft/Banker’s Pay Order

Demand Draft/

Banker’s Pay

Order No.

Issuing Bank/

Branch

Drawee Bank/

Branch

Date of

Issue

Amount

(Rs.)

(Non-Refundable Fee including postal charges)

9. Nationality

……………………………

10 . P la ce of B irt h: ………… …….

.To wn ……… … …

Dist r ict ……………. S t at e …………… …

11. Father’s Name ………………………………………………………………………

12. a) Educational and Professional Qualifications (as on the date of application, Matriculation / SSLC onwards to be supported by attested copies of the certificates. Do not enclose originals.)

Examination

Name of the Institution/ University/ Place

Subjects

Month &

No. of

Percentage

passed

Studied

Year of

attempts

of marks

Passing

obtained

13. Particulars of Sports qualification (as on the date of application to be supported by attested copies of the certificates. Do not enclose originals)

Name of the event Level of representation (District / State / National / International) Year
Name of the event
Level of representation
(District / State /
National / International)
Year of
Position
Remarks
competition
awarded

14. I belong to SC/ST/OBC category and I am enclosing an attested photo copy of the prescribed certificate (Tick the appropriate Box).

DECLARATION

Yes No
Yes
No

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 false or incorrect or not satisfying any of the eligibility criteria according to the requirements of the relative advertisement, my candidature/appointment is liable to be cancelled/ terminated at any stage. I am willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part of the country at its discretion. I hereby agree that any legal proceedings in respect of any matter(s) or claim(s) or dispute(s) arising out of this application and/ or out of the said advertisement can be instituted by me only at Chennai and the Courts/ Forums/ Tribunals at Chennai only shall have sole and exclusive jurisdiction to try the case/ dispute. I undertake to abide by all the terms and conditions mentioned in the advertisement given by the Bank.

PLACE:

DATE

:

SIGNATURE OF THE CANDIDATE