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 varun.12.sharma@gmail.com

*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)