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06/08/2015

HaryanaStaffSelectionCommission:RegistrationPrint

[PARTI]APPLICATIONFORM|HaryanaStaffSelectionCommission[Advt.No.1/2015]

RegistrationNumber

81791568

PostAppliedFor

Storekeeper

CategoryNo.

Cat.No.11

Applicant'sName

MANOJ

Father'sName

GYANSINGH

Mother'sName

KASHMIRADEVI

DateofBirth

6/12/1988

Ageason31.07.2015

26Year7months25days

Gender

Male

MaritalStatus

UnMarried

Nationality

INDIAN

Category

BCB

SubCategory
OutstandingSportsperson

NO

MatricwithHindi/Sanskritor
YES
10+2/B.A./M.A.withHindi
asoneofthesubject?
AadharCardNo.(Desirable)

488895288160

QUALIFICATION

ClassName/Qualification

Passing
Year

University/Board Subject

MarksObtained/Total
Marks

Matric

2005

HBSE

HINDI,ENGLISH,MATHS,SOCIAL
SCIENCE,PHYSICALEDUCATION

371/600

10+2(SeniorSecondary)

2007

HBSE

ENGLISH,HINDI,ECONOMICS,BUSINESS
STUDIES,ACCOUNTING

316/500

OTHER

HaryanaDomicile

YES

BirthPlaceandCountry

REWARIHARYANA/
INDIA

Password

0FDD0D6BBD

ADDRESS

PermanentAddress
HNOD9,DCRUST,MURTHALSONEPATHARYANA,SONEPAT,Sonepat,Pin131039,TelephoneNo8901316916,EmailID
manojrv.99@gmail.com
CorresspondenceAddress
HNOD9,DCRUST,MURTHALSONEPATHARYANA,SONEPAT,Sonepat,Pin131039,TelephoneNo8901316916
DECLARATION:Iherebydeclarethat:

1.Allstatementsmadeinthisapplicationformregardingagelimit,educationalqualifications&experienceetc.aretrue,correct
andcompletetothebestofmyknowledge,belief,recordandnothinghasbeenconcealedtherein.
In the event of any information being found/detected false, incorrect, incomplete and ineligible before or after the
interview/selection/appointmentthenmycandidaturemaybecancelledandanylegalactionasperlawcanbeintiated/taken
againstme.
2.Ihavereadthetermsandconditionsprescribedinadvertisementcarefullyandaccordingly,Iherebyundertaketoabideby
them.I,also,fulfillalltheconditionsofeligibiltyasperrelevantrulesandinstructionsprescribedbyGovernmentofHaryana
fromtimetotime.
3.Ihaveneverbeenconvictedbyanycompetentcourtoflaw.
http://recruitmentportal.in/PMS_HR_REG/RegPrint.aspx

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06/08/2015

HaryanaStaffSelectionCommission:RegistrationPrint

SIGNATURE

Home|HaryanaStaffSelectionCommission|ContactUs

http://recruitmentportal.in/PMS_HR_REG/RegPrint.aspx

Copyright2015
DesignedbyHaryanaStaffSelection
Commission

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