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Federal Bank PERSONAL DATA FORM Campus R

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Roll No. Signature of the candidate 1

Name of the College

(For Office use only)

Date of Campus Process

Date of Interview

P

PEERRSSOONNAALLDDAATTAA

(To be filled up completely by the candidate in his/ her own handwriting)

1 Name of the Candidate (in Block Letters)

2 Sex ( the appropriate box)

Male Female

Please affix your recent passport size photograph

and sign across 3 Date of Birth in DD/MM/YY (as per

SSLC / equivalent certificate) 4 Age (as on 01.11.2012 )

5

Phone with STD: Mobile: E mail ID:

6

Address for Correspondence (in Block letters) with Pin code

7

Permanent Address (in Block letters) with Pin code

8 Do you belong to Scheduled Caste/ Tribe (furnish Yes or No)

If yes, name of the Caste/ Tribe (Attach self attested copy of the certificate)

9

Academic Qualifications: - Attach self attested copies of mark lists / certificates etc. Minimum percentage of marks prescribed for examinations is not allowed to be rounded off. (For example : a candidate who secured only 59.99% of marks will not be permitted to appear for the campus process in case the minimum stipulated percentage is 60%)

Particulars

Name of the School / College & University /

Board

Name of the Course (eg: BA, B Sc, MA,

MBA, etc)

Main Subject / Streams

Date, Month & Year of passing (as per

mark sheet / certificate attached)

% of marks

Standard X

Standard XII

Graduation

Post Graduation

Others

Roll No.

(2)

Roll No. Signature of the candidate 2 10

Details of Computer courses, if any, undergone

(attach certificates)

11

Languages known (underline mother tongue)

Read Write Speak

12 Have you had any major illness, operation or accident? Give details.

13 Do you have any physical disability? If so, details.

14 Your blood group

15

What are your extracurricular activities? (Attach certificates, if any)

16

Have you received any prize/ distinction or scholarship? If so, give details.

17 Have you ever been convicted of an offence? If yes, state details

18 Father’s / Guardia ’s a e

19 Occupation of your Father / Guardian

20 Annual Income of your Father / Guardian

21

If married, name of your spouse with their employment details & annual income

22 How many brothers and sisters do you have?

Broth

ers Sisters

23 Are they employed? If so, state their age and present employment?

24

Do you have any relative in the service of Federal Bank? If yes, 1. Name of the Employee 2. Designation & Branch / Office

now working 3. Period of service 4. Relationship

25

Are you related to any Directors of Federal Bank? If yes,

1. Name of the Director 2. Relationship

26

Have you applied earlier for any post in Federal Bank? if yes, give details.

27

(3)

Roll No. Signature of the candidate 3 28

Name and full address of three reputed persons (referees) who are not your relatives and who know you well

Sl No Name of the person Full communication address Contact no and e-mail ID

(i)

(ii)

(iii)

29

If you are selected for the post

a) Are you ready to work in any Branches / Offices of the Bank

b) Indicate your place of preference, if any (District / State)

1) 2) c) Indicate any specific areas / functions in the

Bank where you would like to work.

d) Whether you have any objection / difficulty in taking up the assignment outside your Home State. If yes, state the reasons.

Eligibility Criteria for Probationary Officers and Clerks for Campus Process 2012-13

Probationary Officers Clerks

Final year and final / penultimate semester students of Postgraduate course in any discipline of any of the universities incorporated by an act of the central or state legislature in India or other educational institutions established by an act of Parliament or declared to be deemed as a University under section 3 of UGC Act, 1956, or possess an equivalent qualification recognized by the Ministry of HRD, Government of India, or approved by AICTE.

Final year and final / penultimate semester students of Degree in Agriculture Sciences or in Agriculture related disciplines, Engineering and Law.

Candidates appearing for the final year / semester of the qualifying examinations as above can also apply. Such candidates must produce a certificate from the Principal / Head of Department/ Registrar/ Director of the University / institution certifying that the candidate is currently in the final year.

Should have obtained minimum 60% marks for SSC or equivalent exam & Plus 2 or equivalent exam, 60% marks in graduation. Non-attainment of minimum marks will disqualify the candidate from the final selection.

Should have cleared all papers of the previous years/ semesters of the qualifying examination as on the date of recruitment process conducted by the Bank.

Candidates shall not exceed 26 years of age as on

01.11.2012.

Candidates selected for appointment will be on probation for a minimum continuous period of 2 years.

Final year and final / penultimate semester students of graduate course in any discipline of any of the universities incorporated by an act of the central or state legislature in India or other educational institutions established by an act of Parliament or declared to be deemed as a University under section 3 of UGC Act, 1956, or possess an equivalent qualification recognized by the Ministry of HRD, Government of India or approved by AICTE.

Candidates appearing for the final year of the qualifying examinations as above can also apply. Such candidates must produce a certificate from the Principal / Head of Department/ Registrar/ Director of the University / institution certifying that the candidate is currently in the final year.

Should have obtained minimum 60% marks for SSC or equivalent exam & Plus 2 or equivalent exam. Shall secure the following % of marks in the qualifying examination (graduation).

1. 55% marks for Science discipline. 2. 50% marks for other streams

Non-attainment of minimum marks will disqualify the candidate from the final selection.

Should have cleared all papers of the previous years/ semesters of the qualifying examination as on the date of recruitment process conducted by secondary schooling (10+2) or equivalent

Postgraduate course or equivalent examination must entail a minimum of 5 years of education after completing higher secondary schooling (10+2) or equivalent

Graduation in Agriculture / Engineering means those who have passed 10+2+4 year course

(4)

Roll No. Signature of the candidate 4

D

DEECCLLAARRAATTIIOONNBBYYCCAANNDDIIDDAATTEE

I, ……….hereby declare that I have gone through the

eligibility criteria and other norms stipulated by the Bank, for appointment as Probationary Officer / Clerk in the Bank and agree to abide by the said stipulations. I understand that if, at any stage I am found not eligible for the post applied for or the declaration given is found to be false / incorrect, my candidature is liable to be cancelled at any stage, without notice and compensation.

I, further declare and submit that (strike off whichever is not applicable)

1. I am pursuing ……….. ………. (Name of the course) and I have appeared / am

appearing for the final / penultimate semester / year of the course.

2. I undertake to produce the original mark list, Degree / Provisional certificate within 30 days of the announcement of results of the qualifying examination

Place : Signature of applicant:

Date: Name of the applicant:

C

CEERRTTIIFFIICCAATTEEFFRROOMMCCOOLLLLEEGGEE

This is to certify that

1. Mr/ Ms ……….. . …pursuing………..………

(Name of the course) is a final year or final semester / penultimate semester student of this college. (please tick (√

) whichever is applicable)

2. He / She has cleared all the papers upto the ……… semester / year. The

University has published results upto ……… semester / year of the course till date.

Place :

Date : Name, Signature & Stamp of authorized signatory of the college

C

CEERRTTIIFFIICCAATTEEFFRROOMMTTHHEEHHRRCCOONNSSUULLTTAANNTT

This is to certify that Mr / Ms………..satisfies the eligibility criteria prescribed by the Bank in all respects.

Place :

Date : Name, Signature & Stamp of authorized signatory of HR Consultant

Note:

If the space provided in any of the columns is not sufficient, please use additional sheets quoting the serial number.

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