CANARA BANK SECURITIES LTD.
(A wholly owned subsidiary of Canara Bank)
Member: BSE, NSE & MSEI
To : Please affix your
The General Manager Canara recent passport
Bank Securities Ltd ASANSOL, size photograph
116, Grand Trunk Rd, and sign it across.
Ushagram, EAST, Ushagram,
Asansol, West Bengal 713303
E-mail : apply@[Link]
Sub : Application for the selection of Chartered Accountant / Network Engineer / Receptionist
on contract – Recruitment process 11/2025.
[To be filled in by the candidate in his/her own handwriting. Please read the Advertisement carefully before filling up this form]
With reference to the above, I am submitting my application for the selection of Chartered Account / Network
Engineer / Receptionist on contract.
1. Full Name :
[In capital letters]
2 Correspondence Address: Permanent Address:
PIN PIN
Phone No. with STD code: Email
Mobile No: Alternate Mobile No (if any)
3. Date of Birth DD MM YYYY AGE: Years Months Days
[As per SSC/SSLC] [As on 30.10.2015]
MALE
4. Gender 5 Religion 6 Nationality Indian
FEMALE
7. Marital Status (Single / Married / Widowed/Divorced/Legally Separated) :
8. Father’s Name
Mother’s Name
Spouse Name
[In capital letters]
9. Category: SC ST OBC Gen (Tick Appropriate Box)
In case you belong to SC / ST / OBC, Name of Sub-Caste or Community Name :
In case you belong to SC / ST / OBC category, indicate the
Serial number of Sub-caste as appearing in the Central Government list :
11
0 . (a) Native Place : District State
(b) Mother Tongue
(c ) Languages Known Read Write Speak
CANARA BANK SECURITIES LTD.
(A wholly owned subsidiary of Canara Bank)
Member: BSE, NSE & MSEI
PAGE:2 \
11. Knowledge in Computers: (Tick Appropriate Box)
Proficient: Working
Knowledge:
12. Educational Qualification [As on 31.10.2025] :
Examination Name of the Month & year % of Class /
Passed University /Board of passing Marks Grade
10th Std /SSC/SSLC
12th Std /PUC/HSC
Graduation
(BA/BSc/BCom etc)
PG if any
Professional
Others
13. Experience Details:
Name and address Nature
of the Employer Designation Duration of work
handled Reasons for
/ Post held From Date To Date of Service
Leaving
(Y/M/D)
Note: Self attested Photocopies of qualification & experience details are to be enclosed
14 Particulars of participation in Sports, Athletics, Scouts, NCC,
Debates, Dramas or other Extra-Curricular activities in :
School, College and elsewhere
15 Hobbies and other interests :
16 a] Have you ever been arrested, prosecuted, kept under detention or
bound down / fined / convicted by a Court of Law or whether any case :
is pending against you in a Court of Law?
If yes, give full details
b] Have you ever been debarred / disqualified by any institution from
appearing at its examination / selection or debarred in any manner :
from any examination or rusticated by any University or any other
educational authority / Institution ? If yes, give full details
c] Is any case pending against you in any University or any other educational
authority / IBPS / Institution at the time of filling up : this form? If yes, give
full details
d] Has any case been filed against you at present or in the past
:
by any Bank, Insurance Company etc., for non-payment of any
loan taken from them ? If so, please give details
CANARA BANK SECURITIES LTD.
(A wholly owned subsidiary of Canara Bank)
Member: BSE, NSE & MSEI
PAGE:3
17 a] In case you are / were an employee of the Government/ Public
Sector / Nationalized Bank/ Municipal Corpn./ Private Sector
:
Organization, please state whether there is any disciplinary case
pending against you or whether any disciplinary case was taken
against you during the last 3 years of your service. If so, please
give details
b] Were you ever removed, discharged/dismissed/made to resign
:
from such service in the past? If so, please give details.
18. Documents/Certificates Submitted along with this application (Xerox copies) : (tick the appropriate box)
Birth Certificate / SSC / 10th/SSLC certificate with DOB
Copies of the mark sheets & certificates from SSC/SSLC/X STD
PUC/10+2/ Intermediate, Graduation & other qualifications etc
Experience certificate, if any
Copy of Caste Certificate in prescribed format (in case of SC / ST / OBC category candidates)
Any other relevant documents (specify below)
19. Any other Information candidate wish to furnish:
Declaration :
I _ hereby declare that I had read Canara Bank Securities Ltd advertisement
Recruitm ent Proces s 02/2 015 published in the company’s website fully & thoroughly and understood the contents and I
undertake to abide by all the terms & conditions. Further, I certify that all the information furnished in this application are true and
correct to the best of my knowledge and belief. I am aware that in case I have given a wrong information or suppressed any
material fact or factual information or if I do not satisfy the eligibility criteria according to the advertisement, then my candidature
will be rejected / services will be annulled even after permanent employment without giving any notice or reasons thereof. I am
willing to serve anywhere in India depending upon the company’s requirement and shall abide by the Service & Conduct rules of
CBSL applicable from time to time. I agree that any legal proceedings in respect of any matter or claims arising out of this
application or out of the said advertisement can be instituted by me at Mumbai only and the courts situated in Mumbai only shall
have sole and exclusive jurisdiction to try any cause / dispute.
Place:
Date : Signature of the Applicant
FOR OFFICE USE
Application Processed / Scrutinized by: Checked by:
Name : Name :
Designation : Designation :
Date: Signature Date : Signature