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ON-LINE APPLICATION FOR COMMON WRITTEN EXAMINATION(CWE) FOR RECRUITMENT OF Officer Scale-I, II and III

36037
Registration # : 6000748713

Full Name :

EDA VIJAYA BABU

Post : Post Code : Category : If Person with Disability : Type of Disability : Percentage of Disability :

Officer Scale-I 01 OBC NO -

Do you intend to use the services of a scribe (only for VI and OC both hands affected by cerebral palsy) ? : NA Whether Children/Family Members of those who died in 1984 Riots? : Whether domiciled in Kashmir Division of the State of J & K during the period 1-1-1980 to 31-12-1989? : Do you have any work experience ? : Are you an Ex-Serviceman ? : Whether you belong to Minority Community ? : Religion to which you belong : Have you passed "local language" as one of the subjects at Matriculation/Xth Standard: Nationality / Citizenship : State/ UT which the Centre of Examination Belongs : State / UT Code : Centre of Examination : Centre Code : Application Fee / Intimation Charges details: Payment Mode: Amount : Reference ID : Transaction Date : Personal Details : Date of Birth : Age completed as on 01.06.2012 : Gender : Husband's Name/Father's Name : Mother's Name : Address for Correspondence : 21-08-1988 23 MALE KRISHNA MOHAN CHANDRAKALA D NO:3-19A RAMALAYAM STREET TIRUVURU MANDAL District State : Pin : Permanent Address : KRISHNA ANDHRA PRADESH 521235 D NO:3-19A RAMALAYAM STREET TIRUVURU MANDAL District KRISHNA ONLINE Rs. 450.00 NO NO NO NO NO YES INDIAN Andhra Pradesh 11 Hyderabad 117

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State : Pin : Contact Details : Email ID : Phone No : Mobile No : Qualification Details (as on 01.06.2012): Exam Passed Graduation: Total Experience (in months) : 10 Other Details : Whether desirous of taking Pre-Exam Training (SC/ST/ Minority Community) : If Yes, Centre for Training : Post Qualification work experience details as on 01.06.2012 (Start from present Employee): Name of the Employer & Nature of Employment SRI RAMA INSTITUTE OF TECHNOLOGY Designation and Rank if any ASST PROFESSOR From(mm/yyyy) 08/2009 To(mm/yyyy) 08/2010 Nature of Duties Performed TEACHING Remark(Reason for Leaving) M TECH ADMISSION Years of Service (YY/MM) 1/0 --Subject /Stream BE in ELECTRONICS Date of Passing 31-05-2009 % of Marks 76.17 Class / Grade First Class vijayababu.e@gmail.com 9390209415 ANDHRA PRADESH 521235

Languages Known TELUGU ENGLISH HINDI

Read YES YES YES

Write YES YES YES

Speak YES YES YES

DECLARATION:
I hereby declare that all statements made in this application are true. complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found untrue or incorrect at any stage or my not satisfying any of the eligibility criteria stipulated, my candidature is liable to be cancelled.

Place:

Date: 25-06-2012

Signature of Applicant

Please retain your Registration No. and Password emailed to you carefully for further reference NOTE: Please DO NOT SEND application printout to IBPS