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PROFORMA FOR APPLICATION

Advertisement No. 1/2007 (R-1)
(Put X mark to the one which is applicable)

1.

Application applied for

BARC, Mumbai / Tarapur/ Kalpakkam
Category I

New BARC Campus, Vizag

Category II

Direct

Post No _________________________Name of discipline/Trade/Post ____________________

2.

Full Name (as per SSC Certificate)

TITL
E
KUM.

FIRST
NAME
PRIYA

MIDDLE
NAME
SHANTARAM

INDIAN

SURNAM
E
MHATRE

3.

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5.

Date of Birth (As per SSC Certificate) : 09 / 04/1983 ( NINE APRIL NINTEEN EIGHTY THREE )

6.

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7.

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Are you domiciled in Jammu & Kashmir during

the period from 1/1/1980 to 31/12/1998?

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 ,
: .....................................................

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