Application Cum Personal Data Form
Application Cum Personal Data Form
Application Cum Personal Data Form
FMSB ID: Date of Interview Venue of Interview Federal bank Employee? Yes No If yes PF No: d d m m y y y y
PERSONAL DATA (To be filled up completely by the candidate in his/her own handwriting) 1 2 3 4 Name of the Candidate (in Block Letters, as appearing in the matriculation or equivalent certificate) Sex ( the appropriate box) d Male d Female
Date of Birth in DD/MM/YYYY (as per matriculation / equivalent certificate) Age (as on 01.01.2013) Phone with STD Code:
years
months
Please affix your recent passport size colour photograph (without dark glasses) and sign across
Mobile: E-mail ID registered with us: Alternate Email ID: Address for Correspondence (in Block letters) with PIN code Permanent Address (in Block letters) with PIN code
If yes, name of the Caste/ Tribe 8 (Attach self attested copy of the certificate) Academic Qualifications: - Attach self attested copies of mark lists / certificates etc. Percentages of marks are not allowed to be rounded off to arrive at the minimum percentage of marks stipulated. ( For example : A candidate who 9 secured only 59.99% of marks will not be permitted to appear for the interview in case the minimum stipulated percentage is 60) Date, Month & Year Name of the School / Name of the Course of passing (as per Main Subjects / % of Particulars College & University / (eg: BA, B Sc, LLB, copy of the mark Streams marks Board MA, MBA, etc) sheet / certificate attached) Do you belong to Scheduled Caste/ Tribe (furnish Yes or No) Standard X
Standard XII
Graduation
Post Graduation
Other Qualifications
FMSB ID:
10
Particulars of Post Qualification work experience (if any) Designation Period of service From To (dd/mm/yy) (dd/mm/yy) Length of service in months Last drawn monthly salary Reason for leaving service
11
Details of Computer courses, if any, undergone (attach self attested copies of the certificates) Details of other relevant exposures (like student apprenticeship, project work, seminars, public speaking etc) Details of period during which candidate was neither employed nor studying Languages known (underline mother tongue)
12
13
Read
Write
Speak
14
15
Place of Domicile with district & state. Have you had any major illness, operation or accident? If yes, give details. Do you have any physical disability? If yes, details? Your blood group What are your extracurricular activities? (attach self attested copies of the certificates, if any) Have you received any prize/ distinction or scholarship? If yes, give details. Have you ever been convicted of an offence? If yes, state details Fathers / Guardians name Occupation of your Father / Guardian Annual Income of Guardian your Father / Employment details Number of children
16
17 18
19
20
21
22 23
24
Annual Income
FMSB ID:
26
How many brothers and sisters do you have? Are your brothers or sisters employed? If yes, state their age and present employment? Whether any of your family members are suffering from any major illness? If yes, give details Do you have any relative in the service of Federal Bank? If yes, 1. Name of the Employee
Brothers
Sisters
27
28
29
2. Designation 3. Branch / Office now working 4. Period of service 5. Relationship Are you related to any Directors of Federal Bank? If yes,
Have you applied earlier for any post in Federal Bank? If yes, give details. Why do you consider yourself suitable for Banking Job? Please emphasize on your notable achievements in the past and also a brief description of your career since leaving college.
32
Name and full address of three reputed persons (referees) who are not your relatives and who know you well Sl No (i) Name Full communication address Contact no and e-mail ID
33
(ii)
(iii)
FMSB ID:
34
35 36 Sl. No
If you are absorbed in Federal Bank; a) Indicate any specific functions in the Bank where you would like to work. b) Are you ready to work in any Branches / Offices of the Bank c) Indicate your place of preference, if any (District / State) d) Whether you have any objection / difficulty in taking up the assignment outside your Home State. If yes, state the reasons. Do you wish to avail an Education Loan from Federal Bank for this program? Date of Loan & Period
Yes / No 1) 2)
Yes / No
Please provide details of all the other loans/ liabilities you have availed till date and the status of the loans. Nature of Loan Institution from which loan is availed Amount availed Amount outstanding
DECLARATION BY CANDIDATE I, ., hereby declare that I have gone through the eligibility criteria and other norms stipulated by the Bank, for admission to PGDBF course of Federal Manipal School of Banking and agree to abide by the said stipulations. I understand that if, at any stage, I am found not eligible for admission to PGDBF course or the declaration given is found to be false / incorrect, my candidature is liable to be cancelled at any stage, without notice and compensation. I also certify that the particulars furnished above are true to the best of my knowledge and belief. Place: Date: Signature of the candidate: Name of the candidate:
Note: If the space provided in any of the columns is not sufficient, please use additional sheets quoting the serial number & FMSB ID.
FMSB ID:
FOR OFFICE USE ONLY (Documents to be verified at the time of interview) (Documents proving academic qualifications, date of birth, valid proof of identity etc are to be verified in original to ascertain the eligibility criteria as reproduced in this application and self attested copies of the same have to be countersigned by the authorized signatory). Sl No 1 Details Particulars Certificate / Document verified
FMSB ID
a 2 b
Age as on 01.01.2013
3 b
% of marks & date in the passing certificate / mark sheet of qualifying examination (dd/mm/yyyy)
Valid proof of identity (PAN card / Passport / Voters ID Card / Driving License or any other valid proof of identification with a photograph)
Place: Date:
FMSB ID: