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ON-LINE APPLICATION FOR TNPSC REGISTRATION

41034
Registration # :

419018855

Notification. No. :

18/2014

Full Name :

M KAVITHA THANGAM

Do you have One Time Registration ID? :

YES

One Time ID :

11885701

Name of The Post Applying for :

Junior Assistant/Bill Collector/Field Surveyor/Draughtsman

Are you a Destitute Widow? :

NO

Are you a Differently Abled Person? :

NO

Are you an Ex-Serviceman ? :

NO

PPO No :

--

Date of Discharge / Probable date of Discharge :

--

Are you a Government Employee? :

NO

Nationality :

Indian

Application Fee / Intimation Charges details:

Payment Mode:

Net Banking

Amount :

75.00

Personal Details :
Date of Birth :

07/11/1987

Gender :

FEMALE

Marital Status :

Married

Spouse's Name :

VIGNESHWARAN

Religion :

Hindu

Candidate's Place of Birth :

NALLANKULAM

Native District :

Tirunelvelli

Father's Name :

V MURUGAVEL

Father's Place of Birth :

Tirunelvelli

Mother Tongue :

Tamil

Mother's Name :

M JAYARAJAKANI

Communal Category :

Backward Class(BC)

Name of the SubCaste :

Nadar/Shanar and Gramani incl. Christian Nadar/Christian Shanar and Christian Gramani

Certificate No :

4893024

Date Of Issue :

12/03/2003

Issuing Authority :

Deputy Tahsildar (Certificates)

Taluk :

Nanguneri

District :

Tirunelvelli

Address for Correspondence :

PLOT NO.A, F-1, THIRUMURUGAN

STREET, SAKTHI NAGAR EXTN.,
MADIPAKKAM

District

Chennai

State :

Tamil Nadu

Pin :

600091

Permanent Address :

PLOT NO.A, F-1, THIRUMURUGAN

STREET, SAKTHI NAGAR EXTN.,

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STREET, SAKTHI NAGAR EXTN.,

MADIPAKKAM
District

Chennai

State :

Tamil Nadu

Pin :

600091

Contact Details :
Email ID :

goldenkavitha@gmail.com

Mobile No :

9626551410

EDUCATIONAL QUALIFICATION PARTICULARS :

Exam Passed

Date of
Publication of

S.S.L.C :

30/05/2003

H.S.C or Equivalent
Qualification :

18/05/2005

Degree :

15/06/2009

Medium of
Instruction

Degree

Major Subject

Board / University

Tamil

N/A

N/A

STATE BOARD

Tamil

H.S.C

English

B.E.

Results

N/A

STATE BOARD

ELECTRONICS AND
COMMUNICATION

Others :

--

Do you claim reservation for Persons Studied in Tamil Medium (PSTM)? :

No

Are you trained person in Survey in ITI, Tamil Nadu?

(Eligible for Field Surveyor and Draughtsman post only)? :

No

ANNA
UNIVERSITY

Whether you are applying with the Educational Qualification as Prescribed in

Prescribed Qualification
the notification or with an equivalent qualification :
Details regarding the prescribed qualification :
Qualification Details :

SSLC

Certificate No :

0014528

Year of Passing :

2003

Name of the Authority/ University :

STATE BOARD

Preferential qualification for per notification :

No
English

Type writing / Short hand Qualification

Cert. No. Issued by Dir. of

Cert. No. Issued by Dir.
Tamil
Technical Education
of Technical Education

Type
Writing

--

--

--

--

Short
hand

--

--

--

--

Computer Qualification (for Typist and Steno-Typist, Grade III) ?

Do you possess Certificate Course in Computer on Office Automation
awarded by the Technical Education Department? :

No

Physical Standards as per notification :

Yes

Name of the Examination Centre District:

Chennai-South

Name of the Examination Centre :

Velachery

Optional Subject :

General Studies with General Tamil (S.S.L.C Standard)

Do you claim Age Concession? :

No

Do You Claim Fee Exemption? :

No

Criminal Case (Registered/Pending/Punishment awarded) :

Not Applicable

Participation in Political Activities (In agitation/As a Member of Political

Organisation/Candidature in Election) :

Not Applicable

Experience Details :
Name of the Organisation

Designation

From(mm/yyyy)

To(mm/yyyy)

Nature of Duty

Previous appearance for Oral Test / Written Test

Name of the Post

Register No.

Year

--

--

--

--

--

--

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DECLARATION:
1. I hereby declare that all the particulars furnished in this application are true, correct and complete to the best of my knowledge and belief. In the event of any information being found false or
incorrect or ineligibility being detected before or after the examination, action can be taken against me by the TNPSC.
2. I hereby declare that I will not be a party to any kind of canvassing on my behalf.

3. I further declare that I fulfil all the eligibility conditions prescribed for admission to the examination.

4. I have informed my employer in writing that I am applying for this Examination.

5. I have gone through the Instructions etc. to candidates and the Commissions notification for this Recruitment before filling up the application form.

6. I declare that I possess the medical standards prescribed for the post(s) which I am now applying.

7. I Certify that I have not been debarred / disqualified by the TNPSC or any other recruiting agency.

8. I am not a dismissed Government Employee.

I accept the above declaration

Place:

Date: 2014-11-09 17:58:23

Please retain your Registration No. and Password emailed to you carefully for further reference

Signature of Applicant