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ON-LINE APPLICATION FOR BANK OF BARODA PROBATIONARY OFFICERS RECRUITMENT PROJECT

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Please paste your recent
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and sign across it. Please
retain atleast 5 copies of
same photograph with you
for subsequent use.

Registration # : 403087
Full Name : Mr NIGAM MUKUL
Category : GENERAL
If Person with Disability : NO
Type of Disability : -- Percentage of Disability : --

Do you intend to use the services of a scribe( only for VH and

--
OH candidates whose writing speed is affected by cerebral palsy) :
Are you candidate who had ordinarily been domiciled in Kashmir
NO
Division of the State of J&K during the period 1-1-1980 to 31-12-1989?
Whether you belong to Religious Minority Community NO
Minority Religion : --
Are you an Ex-Serviceman (Including ECO/SSCO)? NO

Preference for Posting :

Preference1 : DELHI
Preference2 : UTTARAKHAND

Preference3 : UTTAR PRADESH

Are you an employee of Bank of Baroda : NO
If yes,E. C. No :
Nationality : INDIAN
Centre of Examination : Delhi
Centre code : 28

Application Fee / Postal Charges Details :

Transaction ID : M405235
Branch Name : RAJPUR ROAD DEHRA DUN

Branch Code No : 0088

Deposit Date : 20-01-2011

Amount : 300

Personal Details :
Date of Birth : May 11,1984 Age as on on 01.01.2011. : 26
Gender : MALE

Father's Name/ Husband's Name : MR. RAKESH NIGAM

Mother's Name : MRS. PREETI NIGAM

Email ID : nigam.mukul@in.com
Address for Correspondence : 33

KALIKA MARG

DEHRA DUN
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District DEHRA DUN

State : UTTARAKHAND
Pin : 248001

Permanent Address : 33
KALIKA MARG

DEHRA DUN
District DEHRA DUN

State : UTTARAKHAND

Pin : 248001

Contact Details:
Phone No : 0135-2711581

Mobile No: 8909644271

Qualification Details (as on 01.01.2011):

Exams Passed Subject/Stream University / Board Year Of Passing % of Marks

Graduation : COMM GARWHAL 15-06-2004 46.00

Post Graduation : MBA AICTE 15-08-2010 67.00

Possess certificate in computer literacy : YES

Post qualification work experience details as on 01.01.2011 (Start from Present Employer) :

Total Period of Service

Name of the Employer & Designation and Rank if Years of Nature of duties Remark (Reason for
Nature of Employment any From To Service (yy/mm) performed Leaving)
(mm/yyyy) (mm/yyyy)
INDIA MART EXECUTIVE 12/2010 01/2011 0/1 DATA STILL WORKING
MANGEMENT

SAHARA INDIA SALES OFFICER 02/2006 05/2008 2/3 SALES FOR MBA

Other Details :

Whether desirous of taking Pre-Exam Training

--
(SC/ST/PWD/Minority Community) :

If Yes Centre for Training : --

Languages
Read Write Speak
Known
ENGLISH YES YES YES
HINDI YES YES YES

DECLARATION:
I hereby certify that the information furnished above is correct to the best of my knowledge and belief. I have not suppressed any material fact or
factual information in the above statement. I am aware, that, in case, I have given wrong information or suppressed any material fact or factual information or, I
do not satisfy the eligibility criteria according to the advertisement, then my candidature will be rejected/services terminated even after permanent employment
without giving any notice or reasons thereof.

I hereby certify that I am satisfying the eligibility criteria for the post applied for in terms of the advised criteria in respect of age, educational
qualification and experience, etc.

I am also willing to serve anywhere in India. I agree that the Bank has the right to transfer me to any part of the country and/or to any
job position at its sole discretion in terms of applicable staff rules from time to time.

I hereby agree that any legal proceeding in respect of any matter(s) or claims or disputes arising out of this application or out of said
advertisement can be instituted by me only at Mumbai and Courts/Tribunal/ Forums at Mumbai 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:
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Date: 22-01-2011 Signature of Applicant

NIGAM MUKUL
Please retain your Registration No. and Password emailed to you carefully for further reference
NOTE: Please DO NOT SEND application print-out to the Bank