B EL : PR OB A T ION A R Y EN GIN EER S( PE) - 2 0 1 1

A p p lic a t io n F o rm

Application N o.: 359 0 0 8

* Ap p lica tio n fo r th e Post of : PR OBAT ION AR Y EN GIN EER S( PE) - Ele ctr o n ics

P ersonal P arti cul ars

N a m e ( a s it a p p e a r s in
* yo u r SSL C /SSC M r . M AN JU N AT H A D H
ce r tifica te )
Ad d r e ss fo r
* S/O H AN U M AN T H APPA D
C o m m u n ica tio n
M AN JU N T H A N IL AYA
2N D C R OSS,BEH IN D PAR K
SAR ASWAT H IPU R AM ,C H IT R AD U R GA
* C ity/D istr ict C H IT R AD U R GA * Pin C o d e 577501
* Sta te KAR N AT AKA
C o n ta ct N o . w ith ST D
* 8194 - 234 724 M o b ile N o 8762219674
Code
* N e a r e st R a ilw a y St ation C H IT R AD U R GA * N a tio n a lity IN D I AN
* Ge n d e r M AL E
* D a te o f Bir th 22- Ju l- 19 82
* R e ligio n H IN D U
Alte r n a te E-
* E- m a il ID dhm 252@ gm a il.com m a il ID , if d h .m a n ju n a th a 1 7 @ r e d iffm a il.co m
any

Qual i fi cati ons Detai l s

* En g in e e r in g D e g r e e B.E.
* In stitu tio n VT U ,BELGAU M
En g in e e r in g D e g r e e M o n th & Ye a r
* Passed * Ju l- 2 0 0 5
Sta tu s o f Pa ssin g
Pe r ce n ta g e /
C la ss in
* Br a n ch Electr onics & C om m un ica tio n * 5 4 .8 7 /Pa sse d
En g in e e r in g
Degr ee

E m pl oym ent Detai l s

* Ar e yo u Em p lo ye d ? NO
If Ye s, T yp e o f N a m e o f th e
Or g a n isa tio n Or g a n isa tio n
Pa y Sca le
D e sig n a tio n ( C T C fo r
o th e r s)

General I nform ati on

* C a te g o r y SC
Ar e yo u a D o m icile of
* J&K D u r in g 1 .1 .1 9 8 0 to NO
3 1 .1 2 .1 9 9 8 ?
If
 Ye s,In d ica te
Ar e yo u a Pe r so n w ith typ e o f
* NO
D isa b ilitie s ( PWD ) ? d isa b ility a n d %
Pe r ce n ta g e
o f d isa b ility
Ar e yo u a n Ex- Se r vice in
* NO 0 Ye a r s 0 M o n th s
Se r vice m a n ? D e fe n ce
If Ye s, In d ica te b r a nch
o f Ar m e d fo r ce s a n d
d a te o f
d isch a r g e ( D D /M M /YYYY)

Wri tten Test Detai l

L a n g u a g e in
w h ich yo u
* Wr itte n te st ce n te r Bangalo r e En g lish
w a n t to ta ke
th e te st

Dem and Draft Detai l s

* DD No. 947587 * D D D a te 9 - M a y- 2 0 1 1
* D D Am o u n t R s.200
N a m e o f th e Issu in g M IC R N o . o f
* ST AT E BAN K OF IN D IA * 00000 2000
Ba n k DD
Va lid ity o f D D
* D D Pa ya b le a t N ew D elhi * 6 M ON T H S
is

D e cla r a tio n
I her eby declar e th at I have ve r ifie d t h e d e ta ils in d ica te d a b o ve a n d a lso co n fir m th a t a ll th e
in for m ation subm itt ed is cor r ect to th e b e st o f m y kn o w le d g e . At a n y sta g e , if it is fo u n d th a t
a n y of the above in for m a tion is in co r r e ct a n d /o r is su p p r e sse d , th e m a n a g e m e n t o f BEL sh a ll
h a ve the r igh t to ta ke action, a s d e e m e d fit.

Ap plication N o. 35 9008

Pla ce
D a te Sig n a tu r e o f Ap p lica n t
( T o b e sig n e d p r io r to d e sp a tch )
K in d ly s a v e t h is p ag e b y u sin g ' SA VE A S' o p t io n g iv e n in t h e b ro ws e r b e f o re t a k in g t h e p rin t
out.
Print

( Please Pr in t th e fo r m fo r F u r th e r R e fe r e n ce )
A n ackn o wled g emen t messag e h a s n o w b e e n s e n t t o y o u r g iv e n Ema il - ID . Ple a s e
c h eck .
Imp o rt a n t In st ru c t io n f o r C an d id at es:

1 . Atta ch you r p assp or t size photogr a p h ( w ith o u t a tte sta tio n ) in th e sp a ce p r o vid e d b e lo w .
2 . En d o r se your signatu r es in the sp a ce p r o vid e d b e lo w .
3 . Ap p lica tion F o r m r eceived w itho ut tw o p h o to g r a p h s, sig n a tu r e s a t tw o p la ce s a n d D e m a n d D r a ft
o f R s.2 00/- w ill be r ejected.
4 . Se n d the duly co m p leted App lication fo r m a lo n g w ith r e q u isite a m o u n t o f D e m a n d D r a ft a t th e
fo llo w in g addr ess o n or befor e 16 M a y 2 0 1 1 :
Po s t B o x N o : 433 4,
K a lk a ji H ead Po st Of f ice,
N e w D elh i- 110019 .
5 . D o n o t send an y co py of the cer tifica te a lo n g w ith th e d u ly co m p le te d a p p lica t io n fo r m . Or ig in a l
ce r tificates of the shor t listed candid a t e s w ill b e scr u tin ize d / ve r ifie d a t th e tim e o f in te r vie w .

A p p lic a t io n N o .: 3 59008

N a m e : M AN JU N AT H A D H
Ad d r e ss: S/O H AN U M AN T H APPA D
M AN JU N T H A N IL AYA
2 N D C R OSS,BEH IN D PAR K
SAR ASWAT H IPU R AM ,C H IT R AD U R GA
C H IT R AD U R GA - 5 77501
KAR N AT AKA

T e s t D a t e : 2 6 Ju n e 201 1 ( Su n d ay)

Sig n a tu r e o f Ap p lica n t
( in th e sp a ce p r o vid e d )
Ple a se C u t & Affix the Addr e ss Label given below o n th e e n ve lo p fo r se n d in g p r in t ve r sio n o f On lin e Ap p lica tio n F o r m
alongw ith D e m a n d D r a ft o f r e q u isite fe e .

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B E L -2 0 1 1 : Appl i ca ti o n fo r the Po sts o f Pro ba ti o na ry
E ng i neer(PE )

Stream: Electronics
To

POST BOX NO.4334,

KALKAJI HEAD POST OFFICE,
New Delhi-110 019.

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