Online Application_ ESI 2013Ckjkj.pdf

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8/2/2014

Online Application: ESI 2013

Application Form for the post of Social Security Officer
* Application No. 307742 Examination Centre * Examination Centre City selected Chandigarh Social Security Officer

* Post Applied for Personal Particulars * Name * Date of Birth * Gender * Address for communication

GURVINDER KAUR 29-Oct-1991 Female WARD NO.1 NAGAR COUNCIL SIRHAND CITY, VPO.TALANIAN, DISTT.FATEHGARH SAHIB.

* City * State * Email-ID Contact No. * Religion Sub Category, if any Are you a ESI permanent * employee? Are you Resident of State of * J&K (Domiciled during 01.01.1980 to 31.12.1989)? * Are you person with disabilities?

SIRHIND Punjab [email protected] 0160 -125645 SIKH Not Applicable NO NO

* Pin Code

140406

* Mobile No. * Category

9781867875 SC

*

Are you in Govt. Regular Service?

NO if yes, No. of year of Service:

NO INDIAN NO Total Service

If yes, indicate the nature of disability and Percentage of disabilty

%

* Nationality * Whether Ex-Serviceman? If yes, specify Joining Date

Discharge Date

* Do you have working knowledge of computer including use of Office Suites & data base YES

https://jobapply.in/ESI2013/fill_applicationNext.aspx

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8/2/2014

Online Application: ESI 2013

Application No.: 307742 Qualification Details Qualification Name of the Level Qualification Percentage Month Duration of Marks# & Year Name of the Marking Marks Maximum (in (Upto two of University/Board Scheme Obtained Marks Years/Months) decimal Passing places) Mar2009

Main Subject(s)

12th

COMMERCE

Graduation

B.Com.

ACCOUNTANCY, BUSINESS STUDIES, BE&QM, ECOMMERCE, PUNJABI, ENGLISH COST ACCOUNTING, FINANCIAL ACCOUNTING, MANAGEMENT ACCOUNTING, INDIRECT TAX, ENTREAPRENEURSHIP,

1Yr/0

P.S.E.B

Marks

323

450

71.78

2Yr/0

Apr2012

PUNJABI UNIVERSITY PATIALA

Marks

1063

2000

53.15

#Note: In case the Marking Scheme is Grade, please enter the equivalent percentage.

Mode of Payment: --> Payment is not required for women candidates, ESIC Employees and candidates belonging to Scheduled Caste, Scheduled Tribe, Person with Disabilities (PWDs) and Ex-serviceman
I hereby certify and declare that: 1. I am an Indian National. 2. I have re ad the provisions give n in the Adve rtise m e nt. 3. All state m e nts m ade and inform ation give n by m e in this application are true , com ple te and corre ct to the be st of m y k nowle dge and be lie f. In the e ve nt of any inform ation or part of it be ing found false or incorre ct be fore or afte r the e x am /inte rvie w or appointm e nt, action can be tak e n against m e by the ESI and m y candidature /appointm e nt shall autom atically stand cance lle d/re patriate d/te rm inate d. 4. I furthe r de clare that I fulfill all the conditions of e ligibility re garding age , e ducational, profe ssional/te chnical qualifications, e tc. pre scribe d for the post applie d. The e sse ntial qualifications pre scribe d are posse sse d by m e , the proof of which has be e n e nclose d. 5. I will not lay any claim for re fund of non-re fundable application fe e from ESI unde r any circum stance s. Undertaking: I have gone through the advertisement and the General Conditions mentioned therein and fulfil all the conditions/requirements specified therein. I he re by Acce pt and confirm the Unde rtak ing.

Signature of the candidate

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(Please Print the form for Further Reference) Important Instruction for Candidates: Candidates are not required to submit to ESIC either by post or by hand the printouts of their online applications or any other document. They will be required to submit printout of online application along with documents in support of their eligibility etc. in case they are shortlisted for Part – II Examinations.

https://jobapply.in/ESI2013/fill_applicationNext.aspx

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