Вы находитесь на странице: 1из 2

Staff Selection Commission

(Block No. 12, CGO-Complex, Lodhi Road, New Delhi


110003 )
Application Form for the Post of WR10817(ASSISTANT
STORE KEEPER (TECH))
Advertisement No: WR/1/2017
Registration No: 61000377397

Application Status: Application Provisionally Accepted

Name Father Name Mother Name Date of Birth


WAHULE NILESH VITTHAL VITTHAL WAHULE NILAWATI 1998-03-01
Gender Nationality Category
Male Indian SC
Whether ex-serviceman Service Length Date of Discharge Have you been employed If Ex-Serviceman,are you
for any central govt. job eligible for age relaxation?
after your retirement?
No No
Whether PH(Y/N) PH-Code Seeking Age Relaxation? Age Relaxation code
No No
Age (as on closing date of Advt.) Minority Community(Y/N) If VH/Cerebral Palsy,whether If yes, indicate medium
scribe is required ?
19.3 N No
Fee Amount Transaction-ID Transaction Date
Fee Exempted

Educational Qualification
Course Percentage(%) of marks Subject Medium
1) 10+2 EXAMINATION PASS 75.64 MATHEMATICS English
WITH MATHEMATICS AS ONE
OF THE SUBJECTS FROM
RECOGNIZED BOARD OR
EQUIVALENT AND 2) THREE
YEARS SERVICE IN CENTRAL
GOVT. OR A RECOGNIZED
ORGANIZATION OR
INSTITUTION IN HANDLING
ENGINEERING OR
TECHNICAL STORES.

Details of work Experience / Govt. Service rendered)


Organization Name Designation Nature of Duty Period of Service
-
-
-

Address Detail
Communication Address Permanent Address
Village/City: AT POST HARSHI BK , HARSHI BK TQ PAITHAN AT POST HARSHI BK TQ PAITHAN DIST AURANGABAD
District: AURANGABAD District:
State: MAHARASHTRA State: MAHARASHTRA
Pin Code: 431107 Pin Code: 431107
Mobile No:(+91)7741818858
Email Id: knilesh355@gmail.com

Would you like to disclose your details including Marks secured in the Examination as per para 17 of the Recruitment
Notices?
Yes

Declaration
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
Print out of online application along with all the required documents must be submitted to concerned SSC Regional
Office within the specified time as per the notice of examination.

Вам также может понравиться