siz017 BEL Online Application 2017 —7 BHARAT ELECTRONICS Application Form for the post of Probationary Engineer (PE) (Computer Science) [Personal Particulars ADI ation No.479244 * Name RAHUL SHARMA }* Post Applied for Probationary Engineer (PE) (Computer Science) }* Father's Name Mr.Kamal Kant Sharma I* Examination Centre City Preference 1: Delhi Preference 2: Mumbai |, Language in which Question Paper is required Enslish I+ Date of Birth 31-Aug-1995 It Gender Male /* Marital Status UnMarried * Nearest Railway Station Ajmer + Present Address for Communication * Permanent Address Plot no.26, Gali no.2,Surya Nagari, Kotra, Ajmer, Plot n0.26, Gali no.2,Surya Nagari, Kotra, Ajmer, Rajasthan Rajasthan Ajmer Ajmer Rajasthan-305001 Rajasthan-305001 I+ Email-4D rahul82304@gmail.com Alternate Email-I, if any kamalharshkant@gmail.com| Contact No. : * Mobile No, 7877082304 H+ Category uR * Religion Hindu Are you a Domicile of JK }* During 1.1.1980 to No * Nationality INDIAN 31,12,1989? I« Are you person with disabilities? NO It Whether Ex-Serviceman? NO |. Are you a regular employee of organization(s) under Government Departments/ Statutory or Autonomous bodies/Public Sector Undertakings xo hntpesebapplytBELPES2017fl_appleaionNext aspxsiz017 BEL Online Application 2017 Application No.: 479244 n Deta Percentage] Level institute/Any Other|*5!"9} heme) Status |“ gecimal places) Hindi English Maths roth [fing English Maths Fase 2011 | marks 79.80 | FIRST Physics chemistry 5 rath fis cnr at POSE 2013 | Marks 76.00 | FIRST sre, emputer Science & Rajasthan Technical T2017 | wares peared) 67a | Fins Engineering niversity ‘Fhoter In case of CGPA/OGPA [Latter Grades, Please give equivalent percentage of marke@s per the nornis ofthe University /instute. Experience Details, if am Mode of Payment: THROUGH SBI COLLE Payment Reference j= No. * Payment Dat .-May-: No. collect pusso00734 Payment Date 11-May-2017 Reference No.) %500/- (Application Payment Reconcilation Fee) Status Pending I, hereby, certify that the information provided above is true to the best of my knowledge and in case it is found to be false or incorrect or suppressed, the engagement shall be liable to be terminated forthwith without prejudice to any legal / disciplinary action as deemed fit by the Management. I have gone through the full text of the advertisement and agree to all the conditions detailed therein. In case at any time it is found that I am not meeting the eligibility criteria, my candidature may be rejected at any stage. I hereby Accept and confirm the Undertaking. Undertaking: I have gone through the advertisement and the General Conditions mentioned therein and fulfill all the eligibility criteria conditions / requirements specified therein. Thereby Accept and confirm the Undertaking. (Scanned Photograph of the candidate) (Scanned Image of Signature) Home Note: You are advised to take printout on A4 size paper hntpesebapplyivBELPES2017fl_appleationNaxt aspxsir BEL Online Applicaton 2017 Candidates are advised to get a printout of the filled up application for his/her record. The candidate should retain his/her Application Number carefully for generation of Admit Card and for any other information. (Please Print the form for future reference) You are NOT required to send Application Form/any documents/receipt to BEL hntpesebapplytBELPES2017fl_appleaionNext aspx 38