concor india_registration slip.pdf

CONCOR India 2015: Registration Slip Application Form for Post Code: MT/C&O * Registration No. 612373 * Application for the Post of MANAGEMENT TRAINEE (C&O) (Post Code: MT/C&O) * Test Centre selected DELHI Personal Particulars * Candidate Name Mr. VARUN * Father's Name YASHPAL * Address for Communication 145, SARASWATI NAGAR, SINGHAWALA ROAD, AMBALA CITY * City AMBALA * Pin Code 134003 * State HARYANA Contact No. Mobile No. 9527232297 * Date of Birth 10Oct1988 * Gender Male * Category GEN * EmailID [email protected] * Are you a person with Disability(PwD)? NO If yes, Nature of Disability & Degree * Whether exserviceman? NO if yes, Armed Forced Service Period of Service in Armed Force From To * Religion HINDU * Marital Status UNMARRIED * Are you Departmental employee of the CONCOR? NO if yes, Employee No. Essential Qualification Detail Qualification Degree/Diploma Name Specialization/ Discipline Name of Institute/College Year of Passing Course Duration (in years) Marks Obtained Maximum Marks %age CGPA GRADUATION DEGREE B.TECH COMPUTER ENGINEERING VISHWAKARMA INSTITUTE OF TECHNOLOGY 2010 4 8.10 MBA MBA MARKETING SYMBIOSIS INSTITUTE OF MANAGEMENT STUDIES 2 Candidates who have secured marks in CGPA terms are required to mention the equivalent percentage of marks as per University/ Institute norms. Alternatively the marks in CGPA terms should not be less than the 7 points in the scale of 10. * Whether in the final year/semester of MBA/ Equivalent PG Degree or Diploma?YES Details of Payment (Not Applicable for SC/ST/PH/ExServiceman) * Transaction No. 788150 * Transaction Date 08/03/2015 23:06 * Authorization No. 019736 * Amount (including applicable bank charges) Mode of Payment:DEBIT CARD 352.98 Declaration I hereby declare that all statements made in this application are true, complete and correct to the best my knowledge and belief. I understand that in the event of any information being found false or incorrect at any stage or not satisfying the eligibility criteria according to the advertisement, my candidature / appointment is liable to be cancelled / terminated. I hereby agree that any legal proceeding in respect of matters or claims or disputes arising out of this application and / or out of said advertisement can be instituted by me in the N.C.T. of Delhi. Place Date Signature of Applicant Kindly save this page by using 'SAVE AS' option given in the browser before taking the print out. Print

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4/5/2015 ConcorIndia:REGISTRATIONSLIP

http://careers1.concorindia.co.in/Fill_ApplicationNext.aspx?RegNo=612373&DOB=10Oct1988 1/2

CONCORIndia2015:RegistrationSlipApplicationFormforPostCode:MT/C&O

* RegistrationNo. 612373

* ApplicationforthePostof MANAGEMENTTRAINEE(C&O)(PostCode:MT/C&O)

* TestCentreselected DELHI

PersonalParticulars

*CandidateName Mr.VARUN * Father'sName YASHPAL

*AddressforCommunication 145,SARASWATINAGAR, SINGHAWALAROAD,

AMBALACITY

* City AMBALA * PinCode 134003

*State HARYANA

ContactNo. MobileNo. 9527232297

*DateofBirth 10Oct1988 *Gender Male

*Category GEN *EmailID [email protected]

*AreyouapersonwithDisability(PwD)? NOIfyes,NatureofDisability&Degree

*Whetherexserviceman? NOifyes,ArmedForcedServicePeriodofServiceinArmedForce FromTo

* Religion HINDU *MaritalStatus UNMARRIED

*AreyouDepartmentalemployeeoftheCONCOR? NO ifyes,EmployeeNo.

EssentialQualificationDetail

Qualification Degree/DiplomaNameSpecialization/Discipline

NameofInstitute/College

YearofPassing

CourseDuration(inyears)

MarksObtained

MaximumMarks %age CGPA

GRADUATIONDEGREE B.TECH

COMPUTERENGINEERING

VISHWAKARMAINSTITUTEOFTECHNOLOGY

2010 4 8.10

MBA MBA MARKETINGSYMBIOSISINSTITUTEOFMANAGEMENTSTUDIES

2

CandidateswhohavesecuredmarksinCGPAtermsarerequiredtomentiontheequivalentpercentageofmarksasperUniversity/Institutenorms.AlternativelythemarksinCGPAtermsshouldnotbelessthanthe7pointsinthescaleof10.*Whetherinthefinalyear/semesterofMBA/EquivalentPGDegreeorDiploma?YES

DetailsofPayment(NotApplicableforSC/ST/PH/ExServiceman)* TransactionNo. 788150 * TransactionDate 08/03/201523:06

*AuthorizationNo. 019736 *Amount(includingapplicablebankcharges)ModeofPayment:DEBITCARD

352.98

Declaration

Iherebydeclarethatallstatementsmadeinthisapplicationaretrue,completeandcorrecttothebestmyknowledgeandbelief.Iunderstandthatin theeventofany informationbeing found falseor incorrectatanystageornotsatisfyingtheeligibilitycriteriaaccordingto theadvertisement,mycandidature /appointment is liable tobecancelled / terminated. Iherebyagree thatany legalproceeding in respectofmattersor claimsordisputesarisingoutofthisapplicationand/oroutofsaidadvertisementcanbeinstitutedbymeintheN.C.T.ofDelhi.

Place

Date SignatureofApplicant

Kindlysavethispagebyusing'SAVEAS'optiongiveninthebrowserbeforetakingtheprintout.

Print
4/5/2015 ConcorIndia:REGISTRATIONSLIP

http://careers1.concorindia.co.in/Fill_ApplicationNext.aspx?RegNo=612373&DOB=10Oct1988 2/2

(PleasePrinttheformforFurtherReference)