APPLICATION CUM PERSONAL DATA FORM FOR ADMISSION TO FEDERAL MANIPAL SCHOOL OF BANKING BATCH JANUARY 201 Roll No: F E D - - - - - - - (For Office use only) Date of Interview d d - m m - y y y y Venue of Interview Federal bank Employee? Yes No If yes PF No: PERSONAL DATA (To be filled up completely by the candidate in his/her own handwriting) 1 Name of the Candidate (in Block Letters, as appearing in the matriculation or equivalent certificate) 2 Sex ( the appropriate box) Date of Birth in DD/MM/YYYY (as per matriculation / equivalent certificate) Male Female d d - m m - y y y y 4 Age (as on 01.11.2014) years months Phone with STD Code: Mobile: E-mail ID registered with us: Alternate Email ID: Address for Correspondence (in Block letters) with PIN code Please affix your recent passport size colour photograph (without dark glasses) and sign across Permanent Address (in Block letters) with PIN code 6 7 8 Place of Domicile with district & state 9 10 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) Academic Qualifications: - Attach self attested copies of mark lists / certificates etc. Percentages of marks are not allowed to be rounded off to arrive at the minimum percentage of marks stipulated. ( For example : A candidate who secured only 9.99% of marks will not be permitted to appear for the interview in case the minimum stipulated percentage is 60) Particulars Name of the School / College & University / Board Name of the Course (eg: BA, B Sc, LLB, MA, MBA, etc) Main Subjects / Streams Date, Month & Year of passing (as per copy of the mark sheet / certificate attached) % of marks Standard X Standard XII Graduation Post Graduation Other Qualifications 1
11 Particulars of Post Qualification work experience (if any) Name of employer & nature of duties performed Designation Period of service From (dd/mm/yy) To (dd/mm/yy) Length of service in months Last drawn monthly salary Reason for leaving service 12 Details of Computer courses, if any, undergone (attach self attested copies of the certificates) 1 14 Details of other relevant exposures (like student apprenticeship, project work, seminars, public speaking etc) Details of period during which candidate was neither employed nor studying Languages known (underline mother tongue) Read Write Speak 1 16 17 Have you had any major illness, operation or accident? If yes, give details. Do you have any physical disability? If yes, details? 18 Your blood group 19 20 21 What are your extracurricular activities? (attach self attested copies of the certificates, if any) Have you received any prize/ distinction or scholarship? If yes, give details. Have you ever been convicted of an offence? If yes, state details 22 Father s / Guardian s name 2 Occupation of your Father / Guardian 24 Annual Income of your Father / Guardian Name of spouse Employment details Annual Income Number of children 2 If married, furnish details 2
26 How many brothers and sisters do you have? Brothers Sisters 27 Are your brothers or sisters employed? If yes, state their age and present employment? 28 Whether any of your family members are suffering from any major illness? If yes, give details Do you have any relative in the service of Federal Bank? If yes, 29 1. Name of the Employee 2. Designation. Branch / Office now working 4. Period of service. Relationship 0 Are you related to any Directors of Federal Bank? If yes, 1. Name of the Director 2. Relationship 1 Have you applied earlier for any post in Federal Bank? If yes, give details. Why do you consider yourself suitable for Banking Job? Please emphasize on your notable achievements in the past and also a brief description of your career since leaving college. 2 Name and full address of three reputed persons (referees) who are not your relatives and who know you well Sl No Name Full communication address Contact no and e-mail ID (i) (ii) (iii)
4 If you are absorbed in Federal Bank; a) Indicate any specific functions in the Bank where you would like to work. b) Are you ready to work in any Branches / Offices of the Bank c) Indicate your place of preference, if any (District / State) d) Whether you have any objection / difficulty in taking up the assignment outside your Home State. If yes, state the reasons. Do you wish to avail an Education Loan from Federal Bank for this program? Yes / No 1) 2) Yes / No 6 Please provide details of all the other loans/ liabilities you have availed till date and the status of the loans. Sl. No Nature of Loan Date of Loan & Period Institution from which loan is availed Amount availed Amount outstanding Note: Eligibility Criteria for Admission to Federal Manipal School of Banking January 201 batch Graduation (qualifying examination) in any discipline with minimum 60% marks from any recognized university or other institutions established by an Act of parliament or declared to be deemed as a University under Section of U G C Act, 196. Candidates should not exceed 26 years of age as on 01.11.2014 (Candidates should be born on or after 01.11.1988). The place of domicile of the candidate should be in any one of the states/ regions as shown below: Chandigarh, Gujarat, Haryana, Kerala, Karnataka, Maharashtra, Pondicherry, Punjab, National Capital Region (NCR) and Tamil Nadu Graduation course or equivalent examination must entail a minimum of 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 Graduation in Law means those who have passed 10+2+ year course in law or degree in any subject + year course in Law. The percentage of marks obtained by the candidate would be based on the practice followed by the University / Institution from where the candidate has obtained the degree. In case of the candidates being awarded grades / CGPA instead of marks, equivalence would be based on the equivalence certified by the University / Institution from where they have obtained the degree. In case the University / Institution does not have any scheme for converting CGPA into equivalent marks, the equivalence would be established by the Bank by dividing obtained CGPA with the maximum possible CGPA and multiplying the resultant with 100. Year wise / semester wise mark sheet for each year / semester in respect of the qualifying examination from the concerned University should be available. Since the reverse side of the mark sheet contains the instructions, photocopies of both sides of the mark sheets is necessary. DECLARATION BY CANDIDATE I,., hereby declare that I have gone through the eligibility criteria and other norms stipulated by the Bank, for admission to PGDBF course of Federal Manipal School of Banking and agree to abide by the said stipulations. I understand that if, at any stage, I am found not eligible for admission to PGDBF course 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 also certify that the particulars furnished above are true to the best of my knowledge and belief. Place: Date: : Name of the candidate: Note: If the space provided in any of the columns is not sufficient, please use additional sheets quoting the serial number & Application Number. 4
FOR OFFICE USE ONLY (Documents to be verified at the time of interview) (Documents proving academic qualifications, date of birth, valid proof of identity etc are to be verified in original to ascertain the eligibility criteria as reproduced in this application and self attested copies of the same have to be countersigned by the authorized signatory). Sl No Details Particulars Certificate / Document verified 1 Application Number F E D - - - - - - - a Date of Birth (dd/mm/yyyy) d d - m m - y y y y 2 b Age as on 01.11.2014... years. months a Name of the qualifying exam b % of marks & date in the passing certificate / mark sheet of qualifying examination (dd/mm/yyyy) Documents submitted in proof of payment of application fees (Challan / Remittance Slip / E-payment receipt / Registration slip) a Payment Mode CHALLAN / NEFT / ONLINE PAYMENT 4 b Application fees paid SC / ST `200 GENERAL `400 c Transaction / Payment ID d Date of payment - November - 2014 6 7 Place & State of domicile of the candidate Valid proof of identity (PAN card / Passport / Aadhar Card / Voters ID Card / Driving License or any other valid proof of identification with a photograph) Valid proof of address (Aadhar Card / Voters ID Card / Driving License / Ration Card / or any other valid proof of address) 8 Reasons for obtaining declaration (if any) 9 Remarks / Discrepancies observed, if any ( to be filled in by the Official in RED INK) Place: Date: Name, Signature and Stamp of authorized signatory The Federal Bank Limited, Regd. Office, Aluva