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Registration-ID: 98041582 Basic Detail Form

This document contains registration details for an exam applicant named Suresh Kumar Jayaraman. Some key details include: - He is a 25-year-old Hindu male from Chennai, Tamil Nadu - He has an engineering degree from 2010 and a masters in mechanical engineering from 2012 - He provided contact information including an email and mobile number - He paid a 500 rupee fee online on November 9, 2014 for his exam registration

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Suresh Kumar
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63 views

Registration-ID: 98041582 Basic Detail Form

This document contains registration details for an exam applicant named Suresh Kumar Jayaraman. Some key details include: - He is a 25-year-old Hindu male from Chennai, Tamil Nadu - He has an engineering degree from 2010 and a masters in mechanical engineering from 2012 - He provided contact information including an email and mobile number - He paid a 500 rupee fee online on November 9, 2014 for his exam registration

Uploaded by

Suresh Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Registration-ID : 98041582

BASIC DETAIL FORM


Category :

OBC

If Person with Disability:

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 candidates
whose writing speed is affected by cerebral palsy) :
Whether domiciled in Kashmir Division of the State of J&K during the period
1-1-1980 to 31-12-1989 ? :

Whether are you a Children/Family Members of those who died in 1984


Riots? :

Religion to which you belong :

Hindu

Whether you belong to Religious Minority Community ? :

NO

Are you an Ex-Serviceman :

NO

Period of Service(In Months) :


Nationality :

Indian

Centre Of Examination :

CHENNAI

PERSONAL DETAIL FORM


First Name :

SURESH

Middle Name :

KUMAR

Last Name :

JAYARAMAN

Date of Birth :

16/02/1989

Age completed as on 01.10.2014 :

25

Gender :

MALE

Father's Name :

JAYARAMAN P L

Husbands Name :
Mother's Name :

JAYALAKSHMI J

Address for correspondence :

F3 PLOT NO 2 JAYAMS MAHALAKSHMI HOM


INDIRA NAGAR WEST
AGARAMTHEN MAIN ROAD SELAIYUR

District :

KANCHIPURAM

State :

Tamil Nadu

Pincode :

600073

Permanent Address :

F3 PLOT NO 2 JAYAMS MAHALAKSHMI HOM


INDIRA NAGAR WEST
AGARAMTHEN MAIN ROAD SELAIYUR

District :

KANCHIPURAM

State :

Tamil Nadu

Pincode :

600073

CONTACT DETAIL FORM


(STD Code) Phone No :
Mobile No. :

9003679320

Email-ID :

[email protected]

Confirm Email-ID

[email protected]

Educational Qualification Details (as on 01.10.2014):


Exam Passed

Subject/Stream

Date of Passing

% Of Marks

Class/Grade

Graduation/Equivalent

ENGINEERING

01/04/2010

73.73

First Class

Post Graduation :

ME

01/05/2012

78.09

First Class

Professional Qualification :
Others :

LANGUAGES KNOWN
LANGUAGE :

READ

WRITE

SPEAK

TAMIL

YES

YES

YES

ENGLISH

YES

YES

YES

TELUGU

NO

NO

YES

Application Fee / Postal Charges Details :


Payment In :

online

Amount

500

Transaction ID

ASMP3548689148

Transaction Amount

500.00

Transaction Date

09-11-2014 08:19:28

Status

PGS10001-Success

Track No.

469375

PHOTO

SIGN

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.
Place:
Date(yyyy-mm-dd): 2014-11-09
Signature

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