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8/5/2014 Welcome to IBPS - (CWE PO/MT-IV) - Application Form Print

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CWE for Recruitment of Probationary Officer/ Management Trainee in Participating
Organizations- (CWE PO/MT-IV)
Registration Number : 1330986390
Full Name : Pushpendra Kumar Pathak
Category : GENERAL
If Person with Disability : NO
Type of Disability : -
Are you suffering from
cerebral palsy and your writing
speed is affected?
: -
Percentage of Disability : -
Do you intend to use the
services of a scribe
(only for VI and OC whose
writing speed is affected by
cerebral palsy)
: -
Are you a child/ family
member of those who died in
1984 riots?
: NO
Whether domiciled in Kashmir
Division of the
State of J&K during the period
1-1-1980 to 31-12-1989?
: NO
Are you an Ex-Serviceman : NO
Actual service rendered in
defence services which may
be counted for qualifying as
an Ex-serviceman (In Months)
: -
Date of relief from defence
services
: -
Have you joined a
Government job on the civil
side after availing of the
benefits given as an ex-
serviceman
:
Whether you belong to
Religious Minority Community
?
: NO
Religion to which you belong : Hindu
8/5/2014 Welcome to IBPS - (CWE PO/MT-IV) - Application Form Print
http://ibps.sifyitest.com/cwepojul14/registration_print.php?q=MWE2ZmRjYjkyZWY4MTJiZWYwYWM2ODFjNDk5NTFhYzJ8MTMzMDk4NjM5MA== 2/5
Whether serving in Govt./
quasi Govt./ Public Sector
Undertakings (including
Nationalised Banks &
Financial Institutions) ?
: NO
Have you appeared for the
CWE PO/MT held in year 2011
: NO
Have you appeared for the
CWE PO/MT held in year 2012
: NO
Have you appeared for the
CWE PO/MT held in year 2013
: NO
Nationality / Citizenship : Indian
State/UT to which centre of
exam belongs
: New Delhi
Centre of Examination : Delhi
Application Fee / Intimation charges
Payment Mode : ONLINE
Amount : 600.00
Payment Status : PAID
Reference ID : MHDF3439128366
Transaction Date : 05-08-2014
Personal Details
Date of Birth : 20-06-1987
Age completed as on
01.07.2014
: 27
Gender : MALE
Father's Name : Nand Gopal Pathak
Mother's Name : Saroj Pathak
Spouse Name :
Address for Correspondence : J3-244
: DDA Flats Kalkaji
: Behind Alkananda Market
District : Delhi
State : DELHI
Pin code : 110019
Permanent Address : Police Line
: Ban Ganga Road
: Shahdol
8/5/2014 Welcome to IBPS - (CWE PO/MT-IV) - Application Form Print
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District : Shahdol
State : MADHYA PRADESH
Pin code : 484001
Contact Details
Phone No : -
Mobile No : +91 9015639285
Email ID : pathakpushpendrakumar@gmail.com

Qualification Details(as on 11.08.2014)
Exam Passed Degree Subject /Stream Date of Passing % of Marks
Graduation B Pharma Science 16-06-2011 67.88
Professional
Graduation :
PGDM 04-10-2013 64.70
Do you have Operating and working
knowledge in computer systems
: YES
Details of Computer Knowledge : Studied in High School/College/Institute
: I.T. as a Subject
Post Qualification work experience details (as on 11.08.2014)(Start from
present Employer)
Name of the
Employer
Designation From To Nature of
duties
performed
Reason
for
Leaving
Years of
Service(YY/MM)
Nestle India
Ltd
Officer 01/2013 07/2014 Sales and
Marketin
g
N.A 1/7
Total Relevant Experience (in months) : 19
Details of Preference : 1 : Punjab National Bank
2 : Bank of Baroda
3 : Canara Bank
4 : Bank of India
5 : Union Bank of India
6 : Corporation Bank
7 : United Bank of India
8 : Oriental Bank of Commerce
9 : UCO Bank
10 : Indian Overseas Bank
8/5/2014 Welcome to IBPS - (CWE PO/MT-IV) - Application Form Print
http://ibps.sifyitest.com/cwepojul14/registration_print.php?q=MWE2ZmRjYjkyZWY4MTJiZWYwYWM2ODFjNDk5NTFhYzJ8MTMzMDk4NjM5MA== 4/5
11 : Syndicate Bank
12 : Central Bank of India
13 : Allahabad Bank
14 : Andhra Bank
15 : Bank of Maharashtra
16 : Dena Bank
17 : Vijaya Bank
18 : IDBI Bank
19 : Punjab & Sind Bank
20 : Bharatiya Mahila Bank
21 : ECGC
22 : Indian Bank
Whether any prosecution/ detention/
fine/conviction/ sentence against
you has been awarded by any court
of law for any offence?
: NO
If yes, particulars of the same :
Other Details
Whether desirous of taking Pre-
Exam Training (Only for SC/ST/
Minority Community)
: -
If Yes ,Centre for Training : -
Languages
Known
Read Write Speak
Hindi YES YES YES
English YES YES YES
Sanskrit YES YES NO
DECLARATION
I understand that in the event of any information being found untrue or incorrect at any stage/in the
event any circumstances which may impair my fitness for employment in Banks/ organisation/ I do not satisfy
any of the eligibility criteria stipulated, my candidature is liable to be cancelled.
Place:
Date: 05-08-2014 Signature of Applicant
8/5/2014 Welcome to IBPS - (CWE PO/MT-IV) - Application Form Print
http://ibps.sifyitest.com/cwepojul14/registration_print.php?q=MWE2ZmRjYjkyZWY4MTJiZWYwYWM2ODFjNDk5NTFhYzJ8MTMzMDk4NjM5MA== 5/5
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