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    Staff Selection Commission: Combined Graduate Level Examination, 2019

    Uploaded by

    shekhar
    1. This document is an incomplete application form for the Combined Graduate Level Examination, 2019 from the Staff Selection Commission. 2. The applicant, Amber Yadav, has provided some personal details like name, father's name, date of birth, gender, category, education details. 3. However, the application is shown as incomplete as some required fields like fee payment details are missing. The applicant is notified that the application needs to be completed.

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    © All Rights Reserved
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    Staff Selection Commission: Combined Graduate Level Examination, 2019

    Uploaded by

    shekhar
    83 views2 pages
    1. This document is an incomplete application form for the Combined Graduate Level Examination, 2019 from the Staff Selection Commission. 2. The applicant, Amber Yadav, has provided some personal details like name, father's name, date of birth, gender, category, education details. 3. However, the application is shown as incomplete as some required fields like fee payment details are missing. The applicant is notified that the application needs to be completed.

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    1. This document is an incomplete application form for the Combined Graduate Level Examination, 2019 from the Staff Selection Commission. 2. The applicant, Amber Yadav, has provided some personal details like name, father's name, date of birth, gender, category, education details. 3. However, the application is shown as incomplete as some required fields like fee payment details are missing. The applicant is notified that the application needs to be completed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    83 views2 pages

    Staff Selection Commission: Combined Graduate Level Examination, 2019

    Uploaded by

    shekhar
    1. This document is an incomplete application form for the Combined Graduate Level Examination, 2019 from the Staff Selection Commission. 2. The applicant, Amber Yadav, has provided some personal details like name, father's name, date of birth, gender, category, education details. 3. However, the application is shown as incomplete as some required fields like fee payment details are missing. The applicant is notified that the application needs to be completed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    STAFF SELECTION COMMISSION

    BLOCK NO. 12, CGO-COMPLEX, LODHI ROAD, NEW DELHI


    110003

    COMBINED GRADUATE LEVEL EXAMINATION, 2019

    REGISTRATION NO: 30000838025

    APPLICATION IS INCOMPLETE

    1. NAME AS PER 2. NEW/ CHANGED 3. FATHER'S NAME 4. MOTHER'S NAME


    MATRICULATION CERTIFICATE NAME

    AMBER YADAV - BHOOPENDRA PAL SINGH RAJNI YADAV


    6. AGE AS ON
    5. DATE OF BIRTH (DD/MM/YYYY) 7. GENDER 8. CATEGORY
    01/01/2020
    19/09/1998 21.3 MALE OBC
    9. WHETHER PERSON WITH DISABILITY (PWD) ? 9.1 IF YES, TYPE OF DISABILITY (OH, HH,VH, OTHERS)

    NO -

    10. NATIONALITY 11. MARK OF VISIBLE IDENTIFICATION


    CITIZEN OF INDIA MOLE ON LEFT SIDE OF FOREHEAD
    12. MATRICULATION (10th CLASS) EXAMINATION 13. MATRICULATION (10th 14. MATRICULATION (10th
    BOARD CLASS) ROLL NO CLASS) YEAR OF PASSING
    CENTRAL BOARD OF SECONDARY EDUCATION (CBSE) 5630955 2014
    15. DO YOU BELONG TO ECONOMICALLY WEAKER SECTION (EWS) ?
    -
    16. PREFERENCE OF EXAMINATION CENTERS
    EXAMINATION CENTER EXAMINATION CENTER EXAMINATION CENTER
    (FIRST PRFERENCE ) (SECOND PREFERENCE ) (THIRD PREFERENCE )
    DELHI ( 2201 ) HARIDWAR ( 2005 ) HALDWANI ( 2003 )
    17.1. HAVE YOU ALREADY
    JOINED A CIVIL POST BY 17.3. DATE OF DISCHARGE
    17.WHETHER EX- 17.2. LENGTH OF SERVICE IN
    AVAILING BENEFIT OF FROM ARMED FORCES
    SERVICEMAN (ESM) ? ARMED FORCES ( IN YEARS )
    RESERVATION FOR EX- (DD/MM/YYYY)
    SERVICEMAN (ESM) ?
    NO - - -
    18. WHETHER SUFFERING FROM CEREBRAL-PALSY ?
    -
    18.1. DO YOU HAVE A PHYSICAL LIMITATION TO WRITE AND SCRIBE IS REQUIRED TO WRITE ON YOUR BEHALF
    (CERTIFICATE TO THIS EFFECT FROM THE CHIEF MEDICAL OFFICER/ CIVIL SURGEON & MEDICAL
    SUPERINTENDENT OF A GOVERNMENT HEALTH CARE INSTITUTION AS PER NOTICE OF THE EXAMINATION
    WOULD BE REQUIRED AT THE TIME OF EXAMINATION) ?
    -
    18.2. WHETHER SCRIBE IS REQUIRED ? 18.3. WILL YOU MAKE YOUR OWN 18.4. IF SCRIBE IS TO BE ARRANGED
    ARRANGEMENT OF SCRIBE ? BY SSC, INDICATE MEDIUM
    - - -
    19. ARE YOU ALSO APPLYING FOR THE POST OF JUNIOR 20. DO YOU POSSESS EQ FOR THE POST OF JUNIOR
    STATISTICAL OFFICER (MoSPI)? STATISTICAL OFFICER (MoSPI)?
    NO -
    21. ARE YOU ALSO APPLYING FOR THE POST OF 22. DO YOU POSSESS EQ FOR THE POST OF STATISTICAL
    STATISTICAL INVESTIGATOR GRADE II (RGI) ? INVESTIGATOR GRADE II (RGI) ?
    NO -
    23. WHETHER SEEKING AGE RELAXATION ? 23.1 IF YES, AGE RELAXATION CODE
    NO -
    25. DO YOU WANT TO MAKE AVAILABLE YOUR
    PERSONAL INFORMATION FOR ACCESSING JOB
    24. QUALIFICATION DETAILS OPPORTUNITY IN TERMS OF DoP&T'S O.M
    NO.39020/1/2016-ESTT.(B) DATED 21.06.2016 ?

    B. TECH (14) YES

    ADDRESS DETAIL
    26. CORRESPONDENCE ADDRESS 27. PERMANENT ADDRESS
    158/1 VASUNDHRA 16B R 75 JAFRI MOHALLA KANPUR ROAD FATEHGARH

    DISTRICT: GHAZIABAD DISTRICT:FARUKKHABAD


    STATE: UTTAR PRADESH STATE: UTTAR PRADESH
    PIN : 201012 PIN : 209601
    MOBILE NO: 8090781256 EMAIL: [email protected]
    FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE
    NOT EXEMPTED 100 - -
    DECLARATION
    1. I HAVE READ THE NOTICE OF EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS
    MENTIONED THEREIN.

    2. 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 SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING
    DETECTED BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE
    CANCELLED.I AM WILLING TO SERVE ANYWHERE IN INDIA.
    PRINT TAKEN ON: 08/11/2019 5:52:34 PM

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