APPLICATION FORMAT

(Candidate must read the detailed advertisement and must fill the form
strictly in accordance with the instructions contained therein)

LAST DATE OF RECEIPT OF APPLICATION: 25.04.2009

To:
Dy.General Manager (HRD & Compliance)
The Catholic Syrian Bank Ltd.
Head Office, CSB Bhavan
Thrissur-680020
Kerala
INDIA

PLEASE AFFIX
YOUR RECENT
PASSPORT SIZE
PHOTOGRAPH
AND SIGN ACROSS

IN FULL WITH

DATE

With reference to your advertisement in dated

____________, I submit my application for the post as under:

Cadre Post Code

General 1

1. FULL NAME IN BLOCK LETTERS: (Leave one space blank between two
parts of your names)
Shri/Smt./Kum.
 2.ADDRESS FOR CORRESPONDENCE

DIST
STATE PINCODE

3.CONTACT NO (with STD Code): TEL NO. ____________________

MOBILE: ________________ FAX ___________________
E-MAIL _______________________________________

SC ST OTHERS

4. (A) CATEGORY:
Indicate by
mark in the appropriate box
(Please enclose attested photocopy of caste certificate in case
you belong to SC/ST)

In case of SC/ST Candidate

(i) Name of the Caste/Tribe/Class: __________

(ii) Name of the State to which you belong ____________

MALE FEMALE
5. GENDER:

6. a. NATIONALITY ___________________ b. RELIGION ___________

DD MM YY
7. a. DATE OF BIRTH:

b. Relaxation in Age (if claimed): No. of Years uder

category __________
[Please refer to advertisement regarding your eligibility for
claiming relaxation in Age]

c. Place of birth - Town: _____________ Dist __________

(Home Town) State ____________

8. FATHER’S / HUSBAND’S NAME:

 9. PERMANENT ADDRESS:

DIST
STATE PINCODE

10. EDUCATIONAL / PROFESSIONAL QUALIFICATIONS: (As on

31.03.2009)

a) Details of Graduation/ Post Graduation as per eligibility

prescribed in the advertisement (Provide the full information sought
for in the boxes to avoid rejection of the application )
Name of the Degree &
Particulars Discipline Division Percentage
Graduation

Post Graduation

Others

b) Details of Educational Qualifications (From 10th standard onwards)

Month
Examinati Name of the
& Year % Of Class/
on Board/University/ Optional/Specialization
of marks Divn.
Passed Institute
passing

(If space is not sufficient please attach separate sheet)

 11.PARTICULARS OF POST-QUALIFICATION EXPERIENCE

Period of Length of Remarks

Name &
Worked service Service Job (Reason for
address of
as profile leaving
Employer. From To Years Months service)

(If space is not sufficient please attach separate sheet)

12. Level of Computer Literacy:

________________________________________________________
(give details of examination passed in computer applications, if any):

13. Languages known: (Indicate by
mark in appropriate box)

Languages Read Write Speak

14. Post Qualification Experience, if any

Name of Cadre/Post Period Job profile

Organisation held

DECLARATION

I hereby declare that all the statements made in this application are true,
complete and correct to the best of my knowledge and belief. I further declare
that I am a permanent resident of …………………. (place), …………..……. (State).

I understand that in the event of any information being found false or incorrect
at any stage or not satisfying the eligibility criteria according to the requirements
of the relative advertisement, my candidature / appointment is liable to be
cancelled/terminated. I am willing to serve anywhere in India. I agree that Bank
has right to transfer me to any part of the country at its discretion.
 I hereby agree that any legal proceedings in respect of any matter(s) or claims or
disputes arising out of this application and/or out of said advertisement can be
instituted by me only at Thrissur in Kerala and Courts/Tribunals/Forums at
Thrissur, Kerala 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: _____________ Date: __________

Signature of applicant
Enclosure: -
1. Attested photocopy of certificates pertaining to educational
qualifications, age, permanent residence and relevant experience.
2. Copies of certificate for SC/ST
3. Certificate for claiming relaxation in age.

BEFORE MAILING THE APPLICATION, PLEASE CROSS CHECK

WHETHER YOU HAVE CORRECTLY MENTIONED THE:

1. Cadre.
2. The Category i.e., SC/ST and whether the required attested copy of
caste certificate has been enclosed.
3. Address for correspondence.
4. Details for claiming relaxation in age should be accompanied by the
relevant certificate(s).