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    Interview Data Sheet for Actuarial Apprentice (2024)

    Uploaded by

    Dhananjay Madhukar Popalghat
    DJ

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Interview Data Sheet for Actuarial Apprentice (2024)

    Uploaded by

    Dhananjay Madhukar Popalghat
    2 views2 pages
    DJ

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    DJ

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2 views2 pages

    Interview Data Sheet for Actuarial Apprentice (2024)

    Uploaded by

    Dhananjay Madhukar Popalghat
    DJ

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    Space for

    INTERVIEW DATA SHEET


    Photograph

    Post applied for ____________________________

    Roll. No.________________ Category: GEN/SC/ST/OBC (Please tick)

    Name in full : SHRI/SMT/KUMARI ____________________________________


    (in BLOCK CAPITALS) (First Name) (Middle Name) (Surname)

    Father/Husband’s name : ______________________________________________________


    & Occupation
    Present address in full : ______________________________________________________
    for correspondence : _____________________________________________________
    : _____________________________________________________
    : ___________________(Pin Code)__________________________
    E-mail ID 1. : ______________________________________________________
    E-mail ID 2. : ______________________________________________________

    Mobile : No.1 ______________ Mobile No.2 ______________


    Residential Tel.No. with STD Code: _________________________

    Permanent home address : _______________________________________________________


    : _______________________________________________________
    : _______________________________________________________
    : ___________________ (Pin Code) ____________________________

    Date of Birth: ________________ Age as on : 01.09.2023: ___________ Place of Birth____________


    (Years Months)
    Native Place: _____________ State of Domicile:____________________ Home Town: ___________

    Nationality: ____________ Marital Status:____________ No. of Children________________

    If SC/ST/OBC, please name the SC/ST/OBC community: _________, _____________


    Community Name
    Language Known: (1) Regional Language ____________
    (2) Mother tongue ____________
    (3) Other Languages (1)________________ (2)_________________ (3)_______________

    Pan No: ___________________

    ACADEMIC QUALIFICATIONS
    Examination passed Subjects Year of passing Name of School/College/University Class or Division
    offered attended

    (Please attach a separate sheet if additional information on qualification is desired to be furnished)

    PROFESSIONAL QUALIFICATIONS
    Examination passed Subjects offered Year of passing Name of Class or
    Institution/University Division

    Contd…….2
    :: 2 ::

    INTERVIEW DATA SHEET

    Academic distinctions, prizes, scholarships, etc: ____________________________________________

    Are you pursuing further studies: YES/NO Full/Part time: Semester___________________________


    If yes, give details :_________________________________________________

    INSURANCE QUALIFICATIONS IF ANY


    Examination passed Year of passing Name of Institution

    PAST & PRESENT EMPLOYMENT (To be furnished in details)


    Name & full address Designation/post held Period Scales & pay drawn Reason for leaving
    of employer(s)
    From To

    The candidates are advised to satisfy themselves before they appear for the interview that they fulfill the requirement as to age,
    qualification, etc. and if found ineligible, their candidature will be cancelled at any stage of recruitment. Appearing for the
    interview will not automatically confer any right of being selected for the said post.
    DECLARATION
    1. I hereby declare that the information given by me above is complete and correct and if found false, suppressed or
    incomplete, either at the recruitment stage or at any time during the course of the employment, I may be disqualified and my
    services would be liable to be terminated forthwith without any notice.
    2. I also hereby declare that I wrote the examination on the basis of which I have been short-listed for Interview and no other
    person wrote the examination on my behalf and if found false, at any time during the course of the employment, I may be
    terminated from my services and would be liable for prosecution without any notice.

    Reproduce the above text in your own handwriting in presence of the verifying officer in any one of the 4 data sheet:

    Thumb impression:
    (in presence of the verifying officer)

    Date: __________________
    Signature of candidate

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