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SHYAM ONLINE CENTER 19-05-2018, 14:57

Registration for Fireman

Registration Number 2394651


Application Status Submitted
Date of Applying 19 May 2018
First Name PHOOL

Middle Name SINGH

Last Name YADAV

Email Address [email protected]

Mobile Number 7317858676

BASIC DETAILS
Date of Birth 15/07/1998 Gender Male Category OBC
Caste Certificate Number 456173013661 Certificate Date 18/07/2017
Mother's Name CHAMELA DEVI Father's Name RAM GOPAL Alternate Mobile Number 9125102769
Landline Number ID Card AADHAR ID Card Number 749515065874

Physically Disabled? NO Type of Disability Percentage of Disability


Disability Certificate number Certificate Date

Service Certificate
Ex-Service Personnel NO Certificate Date
Number
Date of joining Date of Retirement Name of Organisation
Designation/Discipline/Trade
Have you availed ex-serviceman benefits in civil employment earlier ?

Departmental Candidate NO
Whether three years continuous service in Central Govt ?
Name of
Date of joining Designation/Discipline/Trade
Organisation
Correspondence Address Permanent Address
Address 1 BHAIROPUR , WARD NO 10 Address 1 BHAIROPUR , WARD NO 10
Address 2 HANDIA Address 2 HANDIA
City/Town
City/Town/District ALLAHABAD ALLAHABAD
/District
State Uttar Pradesh State Uttar Pradesh
Pincode 221503 Pincode 221503

Essential Qualification Details

Highest Qualification Achieved HSC

Year of Certificate
Qualification Board / University Percentage
Passing Number
SSC/10th UP BOARD 2013 69.66 55016654
HSC/10 + 2 UP BOARD 2015 72 55016654

DECLARATION

I hereby declare that I am an Indian National

I HEREBY DECLARE THAT ALL THE STATEMENTS MADE IN THE APPLICATION ARE TRUE, COMPLETE AND CORRECT TO THE BEST OF MY
KNOWLEDGE AND BELIEF. I UNDERSTAND THAT 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 .

19-05-2018, 14:57

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