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PROFORMA FOR APPLICATION FOR POSITION IN PMU, NBM - BIRAC

Position Applied for & Position Code: project management unit & Legal – MT/01

1. Name of the Applicant (in Block Letters):AJAY KUMAR JHA

2. Father’s / Mother’s Name: RAMESH JHA

3. Date of Birth (DD/MM/YY): 28/02/1995

4. Age as on 11.06.2018: 23

5. Nationality: INDIAN

6. Marital Status: UNMARRIED

7. Category (General/SC/ST/OBC/Physically Handicapped): GENERAL

8. Postal Address: 161 E , NAER FORTIS ESCORT , SARAI JULLIENA , 110025

(including ,Mobile number/Tel/Email ID) : 8826365709 / ajay28295@gmail.com

9. Permanent address: A 2 LAL BAGH , NEAR SHIV MANDIR , LONI ,GAZIABAD

201102

10. Language Proficiency – state ‘good’ ‘fair’ or ‘poor’

Languages (Specified) Speak Read Write
English GOOD GOOD GOOD
Hindi GOOD GOOD GOOD

11. Educational Qualifications:

Name of Educational Marks obtained (%) Year of
School/College/Institution / qualification passing
University (Graduation onwards)
HOLY MISSION SCHOOL MATRICULATION SGPA - 8 2010
CENTRAL PUBLIC INTERMEDIATE 69% 2012
SCHOOL
JAMIA MILLIA B.A LL.B (HON) RESULT AWAITED 2018
ISLAMIA
(Certificate in original will be examined at the time of interview)

12. Details of experience if any, in chronological order (start from the latest):
Work Experience
Employer (including Post held From To Reason for leaving
current employer)
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13. Have you ever been convicted of a criminal offence or been dismissed from
employment? NO

14. References:
Name and occupation Tel. No./Mobile No./Email

15. Any other relevant information that you may like to furnish : I HAVE DONE DIPLOMA
IN COMPUTER APPLICATION.

DECLARATION

I declare that all the information given in my application is correct to the best of my knowledge. I
understand that any false information supplied could lead to my application being disqualified or my
removal/dismissal if I am appointed.

Place: NEW DELHI

Date: 04-06-2018

Signature: AJAY JHA