aicl application form.pdf
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1/19/2015 Recruitment of Administrative Officer (Scale I) in AICIL Application Form Print
http://ibps.sifyitest.com/aicilaojan15/registration_print.php?q=NDlhZjIwZmI3NjVmNTU3YTdmMDk0ZDc0NzIzNjAxNjF8MjEwMDI0NjI2 1/2
Recruitment of Administrative Officer Scale I
Registration Number : 210024626
Full Name : Sunil Kumar
Name of Discipline : : Generalist
Code No.: : 06
Category : UR
If Person with Disability : NO
Type of Disability :
Percentage of Disability :
Are you suffering from cerebral palsy and your writing speed is affected? :
If Yes, Do you need compensatory time ? :
Whether your dominant (Writing) hand affected ? :
If Yes, Do you need compensatory time ? :
Do you intend to use the services of a scribe (only for VI or OC Candidates)?
:
Whether domiciled in Kashmir Division of the State of Jammu & Kashmirduring the period 111980 to 31121989 : ?
: NO
Do you belong to Religious Minority ? : NO
Religion to which you belong : Hindu
Are you seeking relaxation under widow /divorced women / womenjudicially Separated from their husbands and who are not remarried ?
: NO
Are you Existing Confirmed Employees of Agriculture Insurance Company ofIndia Ltd. : ?
: NO
Are you Existing Confirmed Employees of GIPSA : ? : NO
Are you Resident of Assam State during the period from 01.01.1980 to15.08.1985 ?
: NO
Are you an Emergency Commissioned Officers (ECO), Short Service &Retrenched Commissioned Officers (SSCRO) : ?
: NO
Period of Service :
Nationality : Indian
State/UT (to which centre of exam belongs): * : Haryana
Centre of Examination : Hisar
Application Fee / Intimation Charges Details :
Payment In : ONLINE
Amount : 500.00
Payment Status : PAID
Reference ID : BSBI3631060435
Transaction Date : 14012015
Personal Details
Date of Birth : 07021985
Age completed as on 01.01.2015 : 29
Gender : MALE
Marital Status : Married
Father's Name in Full : : Sh Dharm Pal
Mother's Name in Full: : Smt Pushpa
Spouse Name in Full: : : Minakshi
Address for Correspondence : H. No. 428 Ward No. 9
: Near Balmiki Mandir
: Tohana
District : Fatehabad
State : HARYANA
Pin code : 125120
Permanent Address : H. No. 428 Ward No. 9
: Near Balmiki Mandir
: Tohana
1/19/2015 Recruitment of Administrative Officer (Scale I) in AICIL Application Form Print
http://ibps.sifyitest.com/aicilaojan15/registration_print.php?q=NDlhZjIwZmI3NjVmNTU3YTdmMDk0ZDc0NzIzNjAxNjF8MjEwMDI0NjI2 2/2
Languages Known Read Write Speak
Hindi YES YES YES
English YES YES YES
Punjabi YES NO YES
District : Fatehabad
State : HARYANA
Pin code : 125120
Contact Details
Phone No :
Mobile No : +91 9728019888
Email ID : [email protected]
Educational Qualification Details (as on 01.01.2015):
Exam Passed Degree / Subject / Stream Date ofPassing
% of Marks Class/Grade
Graduation BA 25062006 50.00 Second Class
Post Graduation Others MCA 27022012 53.50 Second Class
Do you have operating/working knowledge ofcomputers
: YES
Details of Computer Knowledge : Done MCA MS Office Windows Inter
Have you passed your Graduation? : YES
Have you passed your Post Graduation? : YES
Have you acquired requisite qualifications afterpassing 10th & 12th Standard Examinations.?
: YES
Work experience details (Start from present Employer)
Name of theEmployer & Nature ofEmployment
Designationand Rank if any
From To Years ofService(YY/MM)
Nature of dutiesperformed
Industry Type RemarkReason forLeaving
OITM HISAR SystemAdministrator
06/2008 01/2015 6/8 Computer LANAdminWindows Inter
Education Working tilldate
Total Experience (in Months) :80
I hereby declare that all the 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 orincorrect at any stage or not satisfying the eligibility criteria according to the requirements of the relative advertisement, my candidature/appointment is liable to be cancelled/terminated. I am willing to serve anywherein India.
Date: 14012015 Signature of Applicant