BHARAT SANCHAR NIGAM LIMITED

REGIONAL TELECOM TRAINING CENTRE THIRUVANANTHAPURAM 695 040

APPLICATION FOR THE TRAINING PROGRAMME ON BSNL CERTIFIED GSM RF ENGINEER Important Notes: (i) Before filling this form, read the brochure carefully. (ii) All entries should be made legibly.

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Name Fathers Name Age and Date of Birth Gender (Please put mark) Nationality Address for Communication Male Female

Please affix one recent passport size Photograph without attestation

Permanent address Educational Qualification (Indicate Degree/Course Completed) Brief description about work experience (If applicable) Mobile No Preferred Batch (Please put mark) Whether hostel facility required? (Please put mark) 11 BCRE 02 Email id BCRE 03 BCRE 04 Branch/ Specialisation Percentage of Marks obtained

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02-07-2012
Yes

16-07-2012

03-09-2012
No

Registration fee: (DD for Rs. 200/, in favour of A.O. (Cash), BSNL, RTTC, Thiruvananthapuram) DD No. Date Name of Bank Branch Address Amount (Rs.)

(Applicant should write Name, Course applied for, on the reverse side of the Demand Draft)

DECLARATION I do hereby declare that all the statements made in the application are true, complete and correct to the best of my knowledge and belief. Place: Date: (Signature of the Applicant)