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Ministry of Home Affairs, Govt. of India

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https://www.onlinesubmit.in/mha/RegisteredUsers/CompleteApplication.

aspx

Ministry of Home Aairs,Govt. of India


Post Applied For :
Personal Informa on: Applicant's Name: Father's /Mother's Name: Rela onship: Category: FATHER GENERAL ADARSHA PARIAL TAPANKUMARPARIAL Gender: Religion: MALE HINDU Date Of Birth: Others Religion: 9/6/1989 Your Photo

ACIO GRADE-II/EXECUTIVE

Applicant's Registra on No :MHA300279243

Are you a Central Govt. Employee with 3 or more years of Con nuous Service? : NO Na onality: Are you an Ex-Serviceman? INDIAN NO State of Domicile: WEST BENGAL

Domicile of J&K during the period 01.01.1980 to 31.12.1989 : NO Qualica on Details: Name of Gradua on Degree: Month & year of Passing: Final Result Declared as on closing date: College/Ins tute Name Name of University aliated: Addi onal Qualica on (if any) : Addi onal Informa on: Contact No. (Only Digits): Email ID: Choice of Examina on Center: Address Line 1: Address Line 2: Address Line 3: City/Town: HOWRAH PIN: Home State to which candidate belong to: WEST BENGAL Are you prepared to serve anywhere in India? YES Declara on I hereby declare that the the informa on given above is true and correct to the best of my knowledge and I fulll the eligibility condi ons for appearing in the recruitment test conducted by Ministry of Home Aairs(MHA) for the post of ACIO-II/Exe. I further declare that in case any of the above informa on is found to be false/incorrect or any ineligibility being detected before, during or a er the test, my candidature for the post of ACIO-II/Exe is liable to be forfeited. 919903898946 adarshaparial@gmail.com Alternate Mobile No. (if any): Alternate Email ID (op onal): KOLKATA NISCHINDA WEST GHOSHPARA POST OFFICE BALLY 711227 State: WEST BENGAL 91 Btech Month: JULY Year: 2011 YES Dura on of the Course: Division/Class of Passing: Years: 4 Months: 0 FIRST

BENGAL INSTITUTE OF TECHNOLOGY AND MANAGEMENT WEST BENGAL UNIVERSITY OF TECHNOLOGY NO

(Applicant's Signature)

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7/22/2013 3:28 PM

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