Spos Clerks Application Proforma

APPLICATION FOR THE POST OF SPECIALIST OFFICERS/CLERKS IN ANDHRA BANK To

Please affix your recent Pass port size photograph and sign it across. Please retain with you three copies of the same photo for subsequent use.

ANDHRA BANK RECRUITMENT PROJECT POST BAG NO.8597 KANDIVALI (EAST) MUMBAI-400 101

With reference to your Advertisement in Employment News dated ,28/10/2006,I submit my application in the prescribed format. 1.FULL NAME IN BLOCK LETTERS(Leave one space blank between two parts of your names 2.ADDRESS FOR COMMUNICATION

State

PIN

Contact Telephone No_______________________STD Code_____________ Fax.No._________________________E.Mail:_______________________________ 3. POST APPLIED FOR (Candidate should send separate application for each post) i) SPECIALIST OFFICER-_______________________ GRADE:_________ POST CODE _________

(Name of the Post)

ii)CLERK a)State applied for _____________________(Name of the State) b) State Code______________________________ (In case the candidate does not fill in the above columns, the same shall be determined based on centre or on his/her permanent address furnished in the application) 4. CENTRE OF EXAMINATION A)SPECIALIST OFFICER Name of the Test Centre :__________________________ Centre Code :_________________________

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B) CLERKS Name of the Test Centre :__________________________ Centre Code :_________________________ (A candidate who applies for vacancies in a particular State will have to appear for the written test at one of the centres within that State only. Applications not confirming to this requirement will be rejected. No request for change of the state or the centre shall be entertained after the submission of the application.) 5. GENDER(Indicate by “X” mark in appropriate box MALE

FEMALE

6.i) CATEGORY TO WHICH YOU BELONG (Indicate by marking”X” in the appropriate Box SC

ST

OBC

GEN

ii) IN CASE OF PHYSICALLY CHALLENGED a) OH VH

HH

Percentage of Disability ______________(Please enclose attested copy of Medical Certificate issued by Medical Board at District Level.

b) ARE YOU ELIGIBLE AND INTEND TO USE THE SERVICE OF A SCRIBE:? (Indicate by “X” mark in appropriate box YES

NO

7.i) DATE OF BIRTH: D

D

M

M

Y

Y

ii)AGE AS ON (31/10/2006) ________________________YEARS (As per School Leaving Certificate/SSLC/SSC) iii)RELAXATION IN AGE (IF CLAIMED) : NO. OF YEARS_______

UNDER CATEGORY__________________

8. PARTICULARS OF FEES(Demand Draft/ Pay Order ) FOR SPECIALIST OFFICERS For General, OBC & Ex-Servicemen candidates: Rs. 200/For SC,ST & Persons With Disabilities : Rs. 35/-

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FOR CLERKS: For General, OBC & Ex-Servicemen candidates: Rs. 150/For SC,ST & Persons With Disabilities : Rs. 35/DETAILS OF DEMAND DRAFT: Name & Address of the Issuing Bank

Name & Address of the Drawee Bank Branch

Date of Issue

Demand Draft/Bank Pay Order Number

Amount(in Rs.)

(Examination Fees should be sent in the form of DDs/Bankers Cheque payable to “Andhra Bank Recruitment Project-2006” Payable at Mumbai only. Cash, Cheque, Money Order, Postal Orders, Postal Stamps will not be accepted. 9.TO BE FILLED IN ONLY BY THOSE SC/ST/MINORITY COMMUNITY CANDIDATES, WHO ARE DESIROUS OF TAKING PRE-EXAMINATION TRAINING(APPLICABLE FOR THE CANDIDATES APPLYING FOR THE POST OF CLERK ONLY) i) WOULD YOU LIKE TO UNDERGO PRE-EXAM TRAINING: (Indicate by “X” mark in appropriate Box. ) YES

NO

ii) IF YES, CHOICE OF CENTRE FOR PRE-EXAM TRAINING (All expenses regarding traveling, boarding, lodging etc. will have to be borne by the candidate for a attending the pre-examination training programme at the Training Centre. DELHI

AHMEDABAD

ERNAKULAM

VIJAYAWADA

TIRUPATHI

BHUBANESHWAR

BHOPAL

HYDERABAD

10.a)Are you an Ex-serviceman YES

NO

b)In case of Ex-serviceman/commissioned officer/Police Officer/Other equivalents, Specify: i)Date of Discharge:_______________ ii)Rank at Present/last held a ) Acting________________w.e.f.___________ b) Substantive_____________w.e.f.___________

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c)Are you a candidate who had ordinarily been domiciled in Kashmir Division of State of Jammu and Kashmir during the period 01.01.1980 to 31.12.1989. YES

NO

d)Whether you belong to Religious Minority Community? YES

NO

If Yes, please state the Religion:______________________ e)

In case of SC/ST/OBC Candidate: i)

Name of the Caste--------------------(Please enclose Xerox copy of the Caste certificate)

ii)Name of the State to which you belong--------------11.FATHER’S/HUSBAND’S NAME

12. NATIONALITY:_______________________ 13.Place of Birth: Place---------------------- District-----------------State------------------14.PERMANENT ADDRESS

State

PIN

15.Details of Educational Qualifications: (from Matriculation/SSC/SSLC/ onwards) Examinatio Name of the Subjects Date, Month, n Institution/University Studied Year of Passing passed 10th Std 12th Std Graduation Post Graduation Others Note: If all details in 15 are not provided, the application will be rejected.

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Percentage of Aggregate Marks

16.Particulars of Post Qualification Experience including the present occupation/job(As on the date of application): Name of the Designation employer(s) / firm and rank if etc. and the nature any and details of activities carried out by the employer

Period of Service From To

Length of Service Years months

Years

Months

Language

Read

Nature of duties performed in detail

Remarks (Reasons for leaving services)

17.Languages Known:_ S.No.

18.Any Other Information:

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Write

Speak

BEFORE MAILING APPLICATION PLEASE CHECK THAT YOU HAVE CORRECTLY MENTIONED 1.The Centre where you wish to appear for the test. In the case of applicants for clerk post, the State and centre for which you have applied for are to be mentioned. 2. Category/Sub-Category and have enclosed copies of necessary certificates for SC/ST/OBC/Persons With Disabilities 3.Details regarding fees(Demand Draft) 4. Address for Correspondence 5. Details of claiming relaxation in age and you have enclosed relevant certificates 6. Details regarding Educational qualifications 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 in the event of any information being found false or incorrect at any stage or not satisfying the eligibility criteria according to the requirements of the relative advertisement, my candidature /appointment is liable to be cancelled /terminated. I am willing to serve any where in India. I agree that Bank has the right to transfer me to any part of the country at its discretion. I hereby agree that any legal proceedings in respect of any matter(s) or claims or disputes arising out of this application and/or out of the said advertisement can be instituted by me only at Hyderabad and Courts/Forums/Tribunals at Hyderabad only shall have sole and exclusive jurisdiction to try the cause/dispute. I undertake to abide by all the terms and conditions mentioned in the advertisement given by the Bank and other further communication/intimation/notification with regard to this recruitment.. PLACE: DATE:

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SIGNATURE OF THE CANDIDATE