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    nagarjuna
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    The applicant, Boyalla Nagarjun Reddy, is seeking registration for the post of Junior Electrical Engineer and has provided details of his 10th class education, B.Tech degree in Electrical Engineering, and contact information in the form.

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    ApplicationFormDraftPrintForAll

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    The applicant, Boyalla Nagarjun Reddy, is seeking registration for the post of Junior Electrical Engineer and has provided details of his 10th class education, B.Tech degree in Electrical Engineering, and contact information in the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    266 views2 pages

    Application Form Draft Print For All

    Uploaded by

    nagarjuna
    The applicant, Boyalla Nagarjun Reddy, is seeking registration for the post of Junior Electrical Engineer and has provided details of his 10th class education, B.Tech degree in Electrical Engineering, and contact information in the form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 2

    STAFF SELECTION COMMISSION

    BLOCK NO. 12, CGO-COMPLEX, LODHI ROAD, NEW DELHI


    110003
    JUNIOR ENGINEER (CIVIL, MECHANICAL,
    ELECTRICAL AND QUANTITY SURVEYING &
    CONTRACTS) EXAMINATION 2019
    REGISTRATION NO: 10000507223

    APPLICATION IS PROVISIONALLY ACCEPTED


    1. NAME AS PER 2. NEW/CHANGED 3. FATHER'S NAME 4. MOTHER'S NAME
    MATRICULATION NAME
    CERTIFICATE
    BOYALLA NAGARJUN
    - BOYALLA YOGI REDDY BOYALLA DROUPATHI
    REDDY
    5. DATE OF BIRTH (DD/MM/YYYY) 6. AGE AS ON 01-01-2020 7. GENDER
    26/05/1997 22.7 MALE
    10. MARK OF VISIBLE
    8. CATEGORY 9. NATIONALITY
    IDENTIFICATION
    UNRESERVED CITIZEN OF INDIA A MOLE ON RIGHT HAND
    11. MATRICULATION (10th CLASS) EXAMINATION 12. MATRICULATION (10th 13. MATRICULATION (10th
    BOARD CLASS) ROLL NO CLASS) YEAR OF PASSING
    CENTRAL BOARD OF SECONDARY EDUCATION
    4216361 2013
    (CBSE)
    14. PREFERENCE OF EXAMINATION CENTERS
    EXAMINATION CENTER ( FIRST ) EXAMINATION CENTER ( SECOND ) EXAMINATION CENTER ( THIRD )

    HYDERABAD ( 8601 ) WARANGAL ( 8603 ) KARIMNAGAR ( 8604 )


    15.WHETHER EX- 15.1. HAVE YOU ALREADY 15.2. LENGTH OF SERVICE IN 15.3. DATE OF DISCHARGE
    SERVICEMAN (ESM)? JOINED A CIVIL POST BY ARMED FORCES ( IN YEARS ) FROM ARMED FORCES
    AVAILING BENEFIT OF (DD/MM/YYYY)
    RESERVATION FOR EX-
    SERVICEMAN (ESM) :?
    NO - - -
    16. WHETHER PERSON WITH DISABILITY 16.1 IF YES, TYPE OF DISABILITY (OH, HH,VH, OTHERS)
    (PWD) ?
    YES OH
    17. DO YOU HAVE A PHYSICAL LIMITATION TO WRITE AND SCRIBE IS REQUIRED TO WRITE ON YOUR BEHALF
    (CERTIFICATE TO THIS EFFECT FROM THE CHIEF MEDICAL OFFICER/ CIVIL SURGEON & MEDICAL
    SUPERINTENDENT OF A GOVERNMENT HEALTH CARE INSTITUTION AS PER NOTICE OF THE EXAMINATION
    WOULD BE REQUIRED AT THE TIME OF EXAMINATION)?
    NO
    17.1 WHETHER SCRIBE IS REQUIRED 17.2 WILL YOU MAKE YOUR OWN 17.3 IF SCRIBE IS TO BE
    ARRANGEMENT OF SCRIBE? ARRANGED BY SSC, INDICATE
    MEDIUM
    NO - -
    18. WHETHER SEEKING AGE RELAXATION? 18.1 IF YES,INDICATE CODE
    NO -
    19. POST(S) APPLYING FOR
    JE- ELECTRICAL ENGINEERING
    20. QUALIFICATION DETAILS
    HIGHEST TECHNICAL QUALIFICATION RELEVANT TO SUBJECT/ STREAM
    THE POST OF INTEREST
    B. TECH ELECTRICAL ENGINEERING
    21. DO YOU BELONG TO ECONOMICALLY WEAKER SECTIONS (EWS) ?
    YES
    22. DO YOU WANT TO MAKE AVAILABLE YOUR PERSONAL INFORMATION FOR ACCESSING JOB OPPORTUNITY IN
    TERMS OF DoP&T'S O.M NO.39020/1/2016-ESTT.(B) DATED 21.06.2016 ?
    NO
    ADDRESS DETAIL
    23. POSTAL ADDRESS 24. PERMANENT ADDRESS
    H-NO 8-5-283/65/64 PLOT NO 64 ROAD NO 1 MADHAVA H- NO 1-15 MOGALAIKOTA ANANTHAGIRI MANDAL
    NAGAR COLONY KARMANGHAT HYDERABAD KODAD SURYAPET DISTRICT
    DISTRICT: RANGAREDDY DISTRICT:SURYAPET
    STATE: TELANGANA STATE: TELANGANA
    PIN : 500079 PIN : 508206
    MOBILE NO: 9492050319 EMAIL: [email protected]
    SIGNATURE

    FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE


    EXEMPTED - - -
    DECLARATION
    1. I HAVE READ THE NOTICE OF THE EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS OF
    THE NOTICE OF THE EXAMINATION.

    2. 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 SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING
    DETECTED BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE
    CANCELLED. I AM WILLING TO SERVE ANYWHERE IN INDIA.
    PRINT TAKEN ON: 14/08/2019 11:11:33 AM

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