CORPORATION BANK - RECRUITMENT OF CLERKS
ONLINE APPLICATION FORM FOR THE POST OF CLERKS
23029
Registration # : 24584 Please paste your
recent passport size
photograph and sign
Registration Date and Time: 08-07-2010 20:19:05 across it.Please retain
atleast 5 copies with
you for subsequent
Full Name : KIRTI RATHI use.
Category : General
Person With Disability : No
Type of Disability : - Percentage of Disability : -
Do you intend to use the services of a scribe : -
Whether domiciled in Kashmir Division of the State of J&K during the No
period 1-1-1980 to 31-12-1989 :
Whether you belong to Religious Minority Community : No
Are you an Ex-Serviceman : No
Are you a disabled Ex-Serviceman (DISXS)? : No
Are you a dependent of an Ex-Serviceman (DXS)? : No
Are you seeking relaxation under widow / divorced women / women No
judicially Separated from their husbands and who are not re-married? :
Nationality : INDIAN
State / Union Territory for which you are West Bengal State / UT code : 28
applying :
Centre of Examination : Kolkata Centre code : 31
Application Fees including Out of Pocket Expenses :
Receipt Number (TSL Number). : 6922
Branch Name : Corboration Bank Branch Code : 052
Brabourne Road
Deposit Date : 08-07-2010 Amount : 200
Personal Details :
Date of Birth : October 13,1986 Age as on 01.06.2010: 23
Gender : FEMALE
Husband’s Name / Father’s Name : GHANSHYAM DAS Mother’s Name : NIRMALA DEVI RATHI
RATHI
Email ID : kirtirathi13@gmail.com
Address for Correspondence : 130 bk pal avenue kolkata-700005
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District : KOLKATA
State : WEST BENGAL Pin : 700005
Permanent Address : 130 bk pal avenue kolkata-700005
District : KOLKATA
State : WEST BENGAL Pin : 700005
Contact Details:
Phone : 91033-25333421 Mobile : 9830281731
Qualification Details(as on 01.06.2010) :
Exams Passed Subject/Stream Year of Passing % of Marks Class / Grade
HSC / Equivalent : science 2005 75.40 First Class
Graduation : b.tech 2010 75.00 First Class
Would You like to undergo Pre-Exam Training (SC/ST/Minority Community/Ex-Serviceman) : No
Centre for Pre-Examination Training : -
Languages Known Read Write Speak
English Yes Yes Yes
Hindi Yes Yes Yes
DECLARATION:
I hereby certify that the information furnished above is correct to the best of my knowledge and belief. I have not suppressed any material fact or
factual information in the above statement. I am aware, that, in case, I have given wrong information or suppressed any material fact or factual
information or, I do not satisfy the eligibility criteria according to the advertisement, then my candidature will be rejected/services terminated
even after permanent employment without giving any notice or reasons thereof.
I hereby certify that I am satisfying the eligibility criteria for the post applied for in terms of the advised criteria in respect of age, educational
qualification and experience etc.
I am also willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part of the country and/or to any job position
at its sole discretion in terms of applicable staff rules from time to time.
I hereby agree that any legal proceeding in respect of any matter(s) or claims or disputes arising out of application or out of said advertisement
can be instituted by me only at Mangalore and Courts/Tribunal/ Forums at Mangalore only, shall have sole and exclusive jurisdiction to try any
cause/dispute. I undertake to abide by all the terms and conditions in the advertisement given by the Bank.
Place : Signature of Applicant
Date : 08-07-2010
KIRTI RATHI
Please retain your Registration No., Password e-mailed to you and copy of print-out carefully for further reference.
NOTE: Please DO NOT SEND application print-out to the Bank
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