Application form for engagement of Actuarial Apprentice

Page 1 of 2 Annexure - A FORMAT OF APPLICATION FOR AC TUARIAL APPRENTICES (Self - Certified photocopies of all relevant documents / certificates must be attached with application.) To, National Insurance Company Ltd, Head office, Premises No. 18 - 0374, Plot no.CBD - 81, New Town, Kolkata - 700156. I hereby submit my application for AC TUARIAL APPRENTICES as below: 1 Name : 2 Gender : 3 Date of Birth : 4 Father’s Name/Husband’s Name : 5 Present Address (For Correspondence) : 6 Permanent Address : 7 Category (UR/OBC/SC/ST) : 8 EWS : 9 PwBD (*) : 10 E - Mail ID : 11 Mobile No. : (*) Please mention category type Qualifications : Educational Qualifications (Class X Onwards): Examination Passed/ Degree Obtained Board/University Year of Passing % marks (Aggregate) Actuarial Exams * IAI or IFOA (specify ) Year - Month of Passing Remarks (if any) * The candidate should have passed or have been exempted from at least 3 actuarial exams conducted by Institute of Actuaries of India (IAI) or Institute and Faculty of Actuaries, UK as per curriculum 2019.

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