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5/28/2018 Online Application_ ESI 2013Ckjkj.pdf
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8/2/2014 Online Application: ESI 2013
https://jobapply.in/ESI2013/fill_applicationNext.aspx
Application Form for the post of
Social Security Officer
* Application No.
307742
Examination Centre
*Examination Centre City
selectedChandigarh
* Post Applied for Social Security Officer
Personal Particulars
* Name GURVINDER KAUR
* Date of Birth 29-Oct-1991
* Gender Female
* Address for communicat ion WARD NO.1 NAGAR COUNCIL SIRHAND
CITY, VPO.TALANIAN,
DISTT.FATEHGARH SAHIB.
* City SIRHIND * Pin Code 140406
* State Punjab
* Email-ID [email protected]
Contact No. 0160 -125645 * Mobile No. 9781867875
* Religion SIKH * Category SC
Sub Category, if any Not Applic able
*Are you a ESI permanent
employee?NO *
Are you in Govt. Regular
Service?
NO if yes, No. of year of
Service:
*Are you Resident of State ofJ&K (Domiciled during
01.01.1980 to 31.12.1989)?
NO
*Are you person with
disabilities?NO
If yes, indicate the nature of
disability and Percentage of
disabilty%
* Nationality INDIAN
* Whether Ex-Serviceman? NO
If yes, specify
Joining Date Discharge Date Total Service
* Do you have working knowledge of computer including use of Office Suites & data base YES
5/28/2018 Online Application_ ESI 2013Ckjkj.pdf
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8/2/2014 Online Application: ESI 2013
https://jobapply.in/ESI2013/fill_applicationNext.aspx
Application No.: 307742
Qualification Details
Qualification
Level
Name of the
QualificationMain Subject(s)
Duration
(in
Years/Months)
Month
& Year
of
Passing
Name of the
University/Board
Marking
Scheme
Marks
Obtained
Maximum
Marks
Percen
of Mar
(Upto
decimplace
12th COMMERCE
ACCOUNTANCY,
BUSINESS STUDIES,
BE&QM, E-
COMMERCE, PUNJABI,
ENGLISH
1Yr/0Mar-
2009P.S.E.B Marks 323 450 71.7
Graduation B.Com.
COST ACCOUNTING,
FINANCIAL
ACCOUNTING,
MANAGEMENT
ACCOUNTING,
INDIRECT TAX,
ENTREAPRENEURSHIP,
2Yr/0Apr-
2012
PUNJABI
UNIVERSITY
PATIALA
Marks 1063 2000 53.1
#Note: In case the Marking Scheme is Grade, please enter the equivalent percentage.
Mode of Payment: --> Payment is not required for women candidates, ESIC Employees and candidates belonging to SchedCaste, Scheduled Tribe, Person with Disabilities (PWDs) and Ex-serviceman
I hereby certify and declare that:
1. I am an Indian National.2. I have read the provisions given in the Advertiseme nt.3. All statements ma de and information given by me in this application are true, comple te and correct to the bes t of my knowledge a nd belief. In the eve
any information or part of it being found false or incorrect before or after the exa m/interview or appointment, action can be tak en aga inst me by the ESand my candidature/appointment shall automatically stand cancelled/repatriated/terminated.
4. I further declare that I fulfill all the conditions of e ligibility regarding age, e ducational, professional/technical qualifications, etc. prescribed for the postapplied. The essential qualifications prescribed are possessed by me, the proof of which has been enclosed.
5. I will not lay any claim for refund of non-refundab le application fee from ESI under any circumstances.
Undertaking: I have gone through the advertisement and the General Conditions mentioned therein and fulfil all the conditions/requirements s pecified therein.I hereby Accept and confirm the Unde rtaking.
Signature of the cand
Print Home(Please Print the form for Further Reference)
Important Instruction for Candidates:
Candidates are not required to submit to ESIC either by post or by hand the printouts of their online applications or any o
document.
They will be required to submit printout of online application along with documents in support of their eligibility etc. in cas
they are shortlisted for Part II Examinations.
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