RECRUITMENT

AND

ASSESSMENT

CENTRE

D EF EN C E R E SEAR C H AND D E V E LOPMENT ORGANISATION (DRDO)
APPLIC ATION FOR M FOR ADVT. No. 102

Item No. ____ Post applied for: ____________________ Subject: _________________________
APPLICATION FEE PARTICULARS (Not Applicable for SC/ST/PH/Women candidates, Rs 50/- for others)

INDIAN POSTAL ORDER NUMBER_______________________________________
Date______________ Amount Rs._______

Affix Recent

(IPOs prior to date of advertisement are not acceptable)

Passport

1. Name in full (Shri / Smt / Km / Dr : _________________________________

Size

(as recorded in Secondary School certificate)

2. Date of Birth:

______

______

Date

Month

(in Christian era in figures)

19______

Photograph

Year

3. (i) Age as on closing date (10-06-2011) of Advt.: ____ yrs ____ months ______ days
(ii) Are you seeking age relaxation (Yes/ No ; if Yes, specify reason)?: ______________________________
(iii) Are you Physically Handicapped* (Yes/ No)?: _______________________________________________
(iv) Are you Ex-serviceman (Yes/ No ; if Yes, specify period of service)?: ________________________
(v) Are you short service commission officer (Yes/ No ; if Yes, specify period)?: ________________________
4. Nationality

:

_________________________

5. Category (GEN/SC/ST/OBC):

______________________________

(if other than Gen. attach certificate)

6. (i) Sex (M/F)

:

__________

(ii) Marital Status: Married (Y/N) : _________________

7. Type of Present Employment, if employed (Central Govt/ State Govt/ Others) : _________________
8. Father’s Name

:

__________________________________

9. Mother's Name

:

__________________________________

10. (a) Address for correspondence :

______________________________________________________

(In India with Pin code, email, fax, phone & mobile)

________________________________________
(b) Nearest Railway Station

:

______________________________________________________

11. Permanent Address :
(with Pin code, email, fax, phone & mobile)

_______
________________________________________________
________________________________________________

IMPORTANT: USE ONLY A4 SIZE PAPER FOR APPLICATION AND ALL OTHER TESTIMONIALS
* Age relaxation will be given to PH candidates as per rules

give details and tick mark the applicable) ?: Year of passing __________ GATE Score ____________________ 12. 12. In case of CGPA / CPI. (if yes. Ph D details: (a) University/Institute : ____________________________________________ (b) Date of registration : ____________________________________________ (c) Thesis defended date : ____________________________________________ (d) Title of Project/ Dissertation/ Thesis : (e) Specialization : ________________________________________________ ____________________________________________ (f) Number of Papers Published in Journals/ Conference (g) Abstract of Thesis (max 250 words) : : ______________ ________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ (h) Does it match with QRs? (Tick √ appropriately) (QR: Qualitative Requirements) Fully Partially Not Matching . (if yes. also give marks in percentage without rounding off along with the conversion formula.-212. (c) Any gap in educational career. give details)?: ____________ 13. (a) Educational Qualifications: (Copies of certificates should be attached) Education Degree # Aggregate Subject(s) University/Board Joining Passing Percentage/ Year Year (in which degree awarded) (Full Name) CGPA* Division Univ rank 10th 12th Graduate Degree PG Degree # * Degree obtained from a recognised university. (b) Are you GATE/NET/ (JRF/LECTURER) qualified.

give details)?: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ (Attach NOC if required) 16. (a) Employment Record (Copies of supporting documents to be attached): Name & Place of Organization * Period Type** Pay Scale Designation From To Total Experience with Grade Pay Salary per annum (yy-mm) Total Experience: ______ Yrs ______Months * In chronological order ** Type of employment: Regular / Ad-hoc / Contract / etc. (b) Does it match with QRs? (Tick √ appropriately) (QR: Qualitative Requirements) Partially Not Matching Nature of Job (Attach details) . mention expected salary with reason)?: ____________________________________________________________________________________ (b) Are you under any contractual obligations to serve Central/State Govt.-314. Professional Training: Period Organization Training Detail(s) From To 1. 3. 4. /Any other PSU or autonomous body (Yes/ No . if yes. (a) Will you join on minimum Basic Pay of the Post? (Yes/ No . if No. 15. 2. Fully 16.

I will. _______________ Occupation Occupation ______________________________ ______________________________ 20. I am found to have concealed/ distorted any material information. Place: Date: Signature of Candidate . Advt No. Declaration I declare that the foregoing information is correct and complete to the best of my knowledge and belief and nothing has been concealed/ distorted. Any other information you may wish to add: _______ _______ _______ _____ 21. my appointment shall be liable to summary termination without notice.No. Date of Interview Post Discipline Result 18. Please justify in 250 words as to why you think you are suitable for this job: ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ 19. If at any time. Have you been interviewed for any recruitment/selection by RAC during the past one year? If yes. if and when required. take up duty in the discharge of government assignments anywhere in India. give particulars: S. Name and telephone/ email of two ‘Refrees’ familiar with your work: (1) (2) Name ______________________________ Name ______________________________ email ______________________________ email ______________________________ Address ______________________________ Address ______________________________ _________________________________ ___________________________________ Telephone No. _______________ Telephone No.-417.

Details of Enclosures attached (Tick √ appropriately) i) Proof of Age ii) Proof of Qualification iii) Proof of Category iv) Fee through IPO/DD v) Proof of Employment vi) Others if any please specify ___________________________ _____________________________________ .-522.

-6UNDERTAKING Applicable for Central/UT/State Govt. Place: Date: Note: o Only Indian nationals are eligible o All columns should be properly filled Signature of Candidate . 102 through proper channel./PSU Official It is certified that I have applied for the post of __________________ against Advt.

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