Priyanka
Priyanka
Priyanka
Sub-Type of Disability : -
Sub-Type of Multiple Disability : -
Are you as per PwBD guidelines eligible to use compensatory time at the : -
time of examination ?
Are you suffering from cerebral palsy and your writing speed is affected ? : -
If Yes, Do you need compensatory time at the time of examination ? : -
Captured
Whether your dominant (Writing) hand is affected ? : -
If Yes, Do you need compensatory time at the time of examination ? : -
I certify that I will upload (in the current application) the certificate from : -
competent medical authority of a Government healthcare institution as
per Ministry of Social Justice and Empowerment, Department of
Empowerment of Persons with Disabilities (Divyangjan) OM No. F. No.
29-6/2019-DD-III dated 10.08.2022 and education qualification of the
scribe accompanying me for the online exam will be one step below my
education qualification.
Are you a child/ family member of those who died in 1984 riots ? : NO
Religion to which you belong : Hindu
Do you belong to Religious Minority Community ? : NO
State code : 44
Centre of Preliminary Examination : Varanasi
Centre of Main Examination : Varanasi
I intend to bring the following ID when appearing for the examination : (I : YES
confirm my name on this ID and this application exactly match)
ID Proof : Aadhaar Card
ID Proof No. : XXXXXXXX8488
Kindly indicate Medium of Paper - how you would like the paper to be : English and Hindi
presented to you ?
Personal Details
District : Jaunpur
Pincode : 222125
Permanent address
Address 1 : RAMPUR
Address 2 : TIYARA
Address 3 : BADLAPUR
State : UTTAR PRADESH
District : Jaunpur
Pincode : 222125
State for GST invoicing : Permanent Address (UTTAR
PRADESH)
Contact Details
: Computer Operations
Bank Preference
Other Details :
Declaration:
I hereby declare that, I have read, understood and agreed the terms and conditions of the notification for the said post and all the
statements made in the application are True, Complete and Correct to the best of my knowledge and belief. I understood that in the
event of any information being found untrue or incorrect at any stage or I am not satisfying any of the eligibility criteria stipulated, and
also in case of creating influence/ undue pressure regarding recruitment shall tantamount to cancellation of my candidature.
I confirm that my name as filled by me in the application form exactly matches with the name in my ID proof
Date: 20-07-2024