Appln Format Cso 01102010

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    ANNEXURE-A

    APPLICATION FOR THE POST OF CHIEF SECURITY OFFICER

    TO:

    SYNDICATE BANK

    PD: HRDD

    MANIPAL 576 104

    UDUPI DISTRICTKARNATAKA STATE

    With reference to your advertisement on Banks website dated ___________, I submit my

    application in the prescribed format.

    1. FULL NAME IN BLOCK LETTERS: (Leave one space blank between two parts of your name)

    Mr./Ms. :

    2. ADDRESS FOR CORRESPONDENCE

    P O S T : P I N :

    S T A T E :

    3. POST APPLIED FOR : Chief Security OfficerSC ST OBC GEN

    4. (i) CATEGORY TO WHICH YOU BELONG :

    Indicate by mark in appropriate box

    (Please enclose photocopy of certificate in case of SC/ST/OBC)

    5. DATE OF BIRTH: DD MM YY

    AGE (As on 01.08.2010): ___________ Years

    6. DETAILS OF NON REFUNDABLE APPLICATION FEE (Demand Draft)

    Name and Address of

    Issuing Bank/BranchDrawn in favour of Date of Issue D.D. No.

    Amount

    (Rs.)

    SyndicateBank Recruitment

    of CSO -2010

    7. YOUR CONTACT NO.:STD Code No. Telephone No. Mobile No.

    E- Mail Address

    PLEASE AFFIX YOUR

    RECENT PASSPORTSIZE

    PHOTOGRAPH

    AND SIGN ACROSS

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    8. INDICATE BY MARK IN APPROPRIATE BOX:

    (i) GENDER : MALE FEMALE

    (ii): MARITAL STATUS:SINGLE MARRIED WIDOW/WIDOWER DIVORCEE

    (iii) Ex-serviceman/Commissioned Officer/Police Officer /Other equivalent, specify

    1. No. of years of service: _________

    2. Date of Discharge : _________

    3. Rank at present/last held A) Acting ______________ w.e.f. ________

    B) Substantive ___________ w.e.f. ________

    (iv) Whether you belong to Minority Community ? Yes No

    (v) In case of SC/ST/OBC Candidate(i) Name of the Caste/Tribe/Class : __________

    (ii) Name of the state to which you belong ____________

    9. FATHERS / HUSBANDS NAME:

    10. NATIONALITY ___________________ RELIGION ___________

    11. PLACE OF BIRTH : Place _________________ Dist. ____________ State ____________

    12. PERMANENT ADDRESS:

    D I S T R I C T

    P O S T : P I N :

    S T A T E :

    13. HOME TOWN: _________________

    14. EDUCATIONAL / PROFESSIONAL QUALIFICATIONS:

    (from 10th standard onwards as on 01.08.2010)

    Exami-

    nation

    Passed

    Name of University/

    Institution studiedSubjects

    Month &

    Year of

    passing

    % of

    Marks

    Class/

    Divn.

    X

    XII

    Degree

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    P G

    15. COMPUTER KNOWLEDGE: INDICATE BY : Yes / No

    16. PARTICULARS OF POST-QUALIFICATION EXPERIENCE (As on 01.08.2010)

    Name of Employer &

    Nature of activities carried

    out

    Designation

    /Rank

    Period of

    service

    Length of

    Service

    Nature of

    duties

    performed

    Remarks

    (Reason for

    leaving service)From To Years months

    (If space is not sufficient please attach separate sheet)

    17. Languages known: (Indicate by mark in appropriate box)Sl. No. Language Read Write Speak

    1

    2

    3

    4

    BEFORE MAILING APPLICATION, PLEASE CHECK THAT YOU HAVE CORRECTLY MENTIONED:

    1. Enclosed certified copies of the following:

    a) Defence/other Service Certificate

    b) Caste/Tribe/Community in the case of candidates belonging to SC/ST/ OBC.

    c) SSLC/X Class Certificate/Marks Card containing Date of Birth.

    d) Degree Marks Carde) Certificate of experience/Discharge.

    2. details of Demand Draft and you have enclosed the same with the application form.

    3. Address for correspondence.

    DECLARATION

    I hereby declare that all the statements made in this 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. I am willing

    to serve anywhere in India. I agree that Bank has right to transfer me to any part of the country at its

    discretion.

    I hereby agree that any legal proceedings in respect of any matter(s) or claims or disputes arising out of

    this application and/or out of said advertisement can be instituted by me only at Udupi and

    Courts/Tribunals/Forums at Udupi only shall have sole and exclusive jurisdiction to try any

    cause/dispute. I undertake to abide by all the terms and conditions mentioned in the advertisement

    given by the Bank.

    Place :_____________ Date :__________ ____________________

    Signature of applicant