FORMAT OF APPLICATION To, The Dy. General Manager(HRM) Dena Bank, Head Office, Dena Corporate Centre, 3nd Floor, Plot No. C-10, 'G' Block, Bandra Kurla Complex, Bandra (East), MUMBAI – 400 051.

Paste Passport size Photograph. Please sign across the Photograph

With reference to your advertisement on Bank’s ___________dated____________, I submit my application as under : 1.

Full Name (Mr./Mrs./Ms.)

Website

:

(In BLOCK LETTERS)

2.

Correspondence address (in BLOCK LETTERS)

3.

Post applied for : Manager (Security).

4.

Category : i.

Indicate category to which you belong by marking X in the appropriate Box SC

ST

OBC

GEN

In case of SC/ST/OBC candidates : a. Name of the Caste / Tribe / Class : b. Name of the state to which you belong ii.

In case of Physically Handicapped : Indicate by

mark against the disability.

OC

VI

HI

Please write percentage of Disability :____________% iii.

Are you an Ex-Serviceman

YES

iv.

Date of birth as per Birth Certificate /

NO

SSC/ School Leaving Certificate:

D

D

M

M

Y

Y

Y

1

Y

and

in

V.

Age as on 01/04/2017:

Y 5.

Y

M

M

Particulars of fee payment details (Indicate by Fee payment Channel

Name of Bank

mark in the appropriate box)

NEFT

Name of Branch with IFSC Code No.

Transaction Date of ID/UTR No. Deposit

Amount

(Fees for SC/ST/OC/VI/HI candidates : Rs. 50/- and for all other candidates : Rs. 400/-) 6.

Gender :

Male

Female

7.

Nationality :

8.

Whether you belong to Minority community :

9.

Place of Birth :

Yes

No.

Town : District : State :

10.

Father’s / Husband’s name :

11.

Education and professional qualification (Matriculations /SSLC onwards) to be supported by attested true copies of the certificate. Do not enclose originals. Examination passed

Name of the subjects Institution/University studies

2

Date-MonthYear of Passing

Percentage of Marks

12.

Particulars of Post-Qualification Experience including the present occupation/job (as on the date application): Name of the employer(s) Company, etc., and the nature and details of activities carried out by the employer

Designation period of service

Length of Nature of service duties Years/Months performed in details

13.

Write in brief your significant achievements in the field : _________________________________

14.

Mention your core strengths :

Remarks (Reasons for leaving service/s)

__________________________________ 15.

Your Computer literacy level: __________________________________

16.

Describe how you consider yourself competent and suitable for the post applied for : _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________

17.

If belongs to SCX/ST/EXSM/OC/VI/.HI category and if yes, enclose photo copy of the prescribed certificate.

18.

Permanent address :

19.

Your contact No.

20.

Tel NO. (with STD Code :

_____________________________

Mobile No.

:

_____________________________

FAX No.

:

_____________________________

Email Add.

:

_____________________________

Details of enclosures attached with the application form :-

A.______________________________________________ B.______________________________________________ C.______________________________________________ D.______________________________________________

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E.______________________________________________ F.______________________________________________ DECLARATION I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that tin 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 without any further reference to me. Even though it is found after my appointment in the Bank that the particulars furnished by me are incorrect or suppressed, my services are liable to be terminated without any notice. I am willing to serve anywhere in India. I agree that the Bank has the 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 claim(s) or dispute(s) arising out of this application and/or out of the said advertisement can be instituted by me only at Mumbai and the Courts/Forums/Tribunals at Mumbai only shall have the sole and exclusive jurisdiction to try the case/dispute. I undertake to abide by all terms and conditions mentioned in the Advertisement dated 10/04/2017 of the Bank. Place : Date :

SIGNAUTRE OF THE CANDIDATE

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