6/26/2017 TeachersRecruitmentBoard

ApplicationNo. 564035

Candidate'sName SKRISHNAKUMAR

DateofBirth 27/08/1994

Age(Ason1stJuly,2017) 22years,10months,and5days

Gender Male

Community OC

Father'sName SUNDARAVARADAN
Mother'sName SHYMALA
AreyoudifferentlyabledandeligibleasperG.O.Ms.No.13Welfareof No
Differentlyabledperson(DAP.3.2)Department,dated02.03.2016?
CategoryofPostappliedforEngineeringSubjects&NonEngineering
EngineeringCourse
Subjects.
HaveyoupossessedfirstclassUGdegreeinB.E/B.Tech? Yes
EmailID ssri.kod.krish@gmail.com
MobileNo. 9585493420

NameOfExam Board/University MediumOfInstruction Subjects Month&YearOfPassing

SSLC StateBoard English 032009

HSC StateBoard English 032011

UG PONDICHERRYUNIVERSITY English MechanicalEngineering 052015

HaveyoustudiedtheprescribedqualificationsasanIntegratedCourse? No
Postappliedfor MechanicalEngineering
Doyouhaveteachingexperience,aftercompletingalltherequired
qualificationsforthepostofLecturersinGovernmentPolytechnic No
Colleges?
ChoiceofExamDistrict Villupuram
AddressforCommunication
aAddress1 NO,12REDDIYARSTREET
bAddress2 KODATHUR
cAddress3 PUDUCHERRY
District PUDUCHERRY
State Puducherry(formerlyPondicherry)
PinCode 605501
FeePaymentDetails
a.TransactionNumber221816708 b.DateofTransaction2017062615:55:09 c.Amount600.00(ConvenienceCharges&ServiceTaxasapplicable)

Declaration

1.Ihavegonethroughtheinstructionstothecandidatesandtheboard'snotificationforthisrecruitmentbeforefillinguptheapplicationform.
2.Iherebydeclarethatalltheparticularsfurnishedinthisapplicationaretrue,correctandcompletetothebestofmyknowledgeandbelief.
3.Iamawarethatintheeventofanyinformationbeingfoundfalseorincorrectatanystageormyineligibilitybeingdetectedatanytime,TRBisatlibertytodisqualifymycandidatureatany
stageandalsocancelmyselection,ifmade.
4.IherebydeclarethatIwillnotbeapartytoanykindofcanvassingonmybehalf.
5.Iwillproducethenecessarycertificatesordocumentaryproofrelatedtotherecruitmentatthetimeofcertificateverification,ifcalledforanduponselectionorthereafter.
6.Ihaveverifiedthecorrectnessoftheparticularsfurnishedintheapplicationandwilltakeaprintoutoftheapplication.

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