Support Registration News Desk Jan 2, 2025 0 Registration Form Registration Number: Date: Personal Name (In Block Letters): Passport Size Photograph: Date of Birth: Age: Gender: Male Female Others Marital Status: Single Married Other Address: Pin Code: Mobile Number: Alternate Number: E-mail ID: Educational Qualification: Year of Passing: Specialization (if any): Documents Passport Size Photo PAN Card Address Proof Highest Qualification Certificates Bank Details (Cancelled Cheque or Passbook Copy) Proof of Retirement (if applicable) Any Other Relevant Certificates or Documents Professional Current/Previous Department Served: Designation Held: Total Work Experience (in years): Year of Retirement (if applicable): Any Skills/Certifications Relevant to the Role: Nominee Name of Nominee: Contact Number of Nominee: Additional How Did You Learn About This Presentation? Poster Pamphlet Invitation Paper Insert Paper Ad Referral Other Reason for Joining: Languages Known: Hobbies/Interests (Optional): Do You Have Any Medical Conditions We Should Be Aware Of? Bank Bank Name: Account Number: IFSC Code: Branch Name: Declaration I hereby declare that the information provided above is true and correct to the best of my knowledge. I understand that any false information may lead to disqualification of my application. I also consent to the verification of my documents and the use of my personal data for this application process. Signature: Signature Image: Date: Submit
