10/26/2015

UttarakhandPublicServiceCommision

UttarakhandPublicServiceCommission,Haridwar

,
YourIPis14.139.241.50
[fieldsmarkedwith*(asterisk)aremandatory]

ApplicationFormForUttarakhandPublicServiceCommission[UttarakhandJudicialServiceCivil
Judge(J.D.)]Exam2015

(
)2015
YOURAPPLICATIONFORTHEEXAM/SELECTIONhasbeenSUBMITTED,Follow
Instructionsgivenbelow//

RegistrationNo.

PCSJ150017590

PersonalDetails/

Name/:

ARPITJAIN

Gender/

Male

DateofBirth/:

02121992

Father's/Husband'sName/

SUDHIRJAIN

/:
Mother'sName/:

ANJUJAIN

Nationality/

CitizenOfIndia
NO

DomicileOfUttrakhand/

RoomNoB212
NewBoysHostel,NationalLawInstitute
University
KerwaDamRoad
Bhopal462044
917552696965

Address/:

PhoneNo.withSTDCode/

:
MobileNo./
:

8989533190

EMail/
:

arpit.tishu@gmail.com

CategoryDetails/

PhysicallyHandicapped/

NO

Reservation/:
[(Category/SubCategory)/
(
/
)]

GEN

CertificateoftheClaimed
Category/SubCategory:
EssentialEducational
Qualification/

NoDomicile
1:GraduationinLaw+KnowledgeOfHindiin
DevNagriLipi+BasicComputerKnowledge

EssentialEducationalQualification/

Exam

Board/University

High
School/Higher
Secondary

cisce

Intermediate

cbse

LawGraduation

Year

2008

2010

universityofpetroleum
2015
andenergystudies

DateOfAcquiringEssential
EducationalQualification:

Subject

science,english,hindi,socialsceince,
computer,environmentalstudies
Science

Law

MarksObt./ %Marks
TotalMarks/
Grade
623/700

89

493/600

82.16

3.24/4.00

84.8

30052015

http://ukpscappl.gov.in/soappcsj/home/photostamp/exam=PCSJ&yr=2015&id=PCSJ15001759&cn=ARPIT%20JAIN&fn=SUDHIR%20JAIN&mn=ANJU%20JA

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10/26/2015

UttarakhandPublicServiceCommision
PreferentialEducation
Qualification:
NO
NO

DoyouhavetheCertificateof
theClaimedPreferential
Qualification
OtherDetails

No

AreyouEmployeeOfAny
(StateGovt./Govt.OfIndia/Semi
Govt.):
CandidatePictureandSignature

ExaminationCentre/

Dehradun

FeeRemissionClaimed/

No

Claimingagerelaxation/

No

pursuingLLMCriminalLawfromNationalLaw
InstituteUniversityBhopal

Experience(Ifany)/

():

___________(Manuallyfilledbythecandidateon
printout)

No.OfEnclosures/

No

Haveyoueverdebarfrom
UPSCoranyStatePSC,IfYes
thenprovidethereasonand
duration./

Declaration/
1.
/

/
|

2.
,/

|/

3.
,/

_____________

Instructions/

Note1:Taketheprintoutofthecompletedapplicationformandthecopyofchalan.
Note2:CandidatemustdepositthefeebychalanatanyoftheSBIbranch.
Note3:Candidatemustkeephimself/herselfacopyofcompleteapplicatonformandchalan,
WhichwillberequiredforfurtherreferencetoUKPSC.

/Print
...

/SBIPrintedBankPayInSlip

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UttarakhandPublicServiceCommision

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