DEFENCE RESEARCH & DEVELOPMENT ORGANISATION (DRDO)

RECRUITMENT & ASSESSMENT CENTRE (RAC)

CAMPUS RECRUITMENT (TALENT SEARCH SCHEME )- 2011

APPLICATION FOR THE POST OF SCIENTIST `B

1.
2.

Name of Institute
Subject / Branch

3.

Year of passing

4.

Name in full (Shri/Smt/Kum) :

(in block letters)

5.

(a) Date of Birth

(in Christian era in figures)
(b) Age as on 1st Jan 2012 : __________Years
_________ Days

6.

Nationality :

7.

Marital Status:

8.

Parents Names:

9.

Address for correspondence:

(In block letters with pin code)

Phone/Mob. No.
Email
10.

Permanent Address:
(In block letters with pin code)
Phone/Mob. No.
Email

11.

Nearest Railway Station:

Recent Passport
Size Photograph

__________ Months

12.

Whether belong to SC/ST/OBC/PH:

(if yes attach prescribed certificate)

13.

Percentile score in GATE Examination &

Year of passing (if applicable)
Contd.

14.

Educational Qualifications:
(a)

B.E / B.Tech
Year

Semester

I
II
III
IV
V
VI
VII
VIII

II
III
IV

(b)

Name of Institute :
Year of
Passing /
Appearing

Subject/Branch

M.E / M.Tech (Inegrated/Dual)

Year

Semester

I
II
III
IV

II

Year of Passing /
Appearing

16.
17.

Div
/
Clas
s

Rank/
Positio
n

Name of Institute :
Subject/Branc
h

Aggregate % of marks/ CGPA upto last Sem. :

15.

% of Marks/
CGPA

% of Marks/
CGPA

Div
/
Clas
s

% / CGPA

Whether receiving Scholarship/ Fellowship from any agency?

indicate:(i)
Name of Agency
(ii)
Amount of Fellowship/Scholarship
(iii) Duration (since when)
(iv) Bond, if any
Details of relative(s) working in DRDO (if any)
Extra Curricular Activities.

If yes,

Rank/
Positio
n

18.

A.
S.
No.

B.
S.
No.

Are you sponsored candidate or earlier employed ? If yes, Please give

details:
For students of BE/BTech/BSc Engg etc.
Name of
Candidate

Categor
y (UR/
OBC/
SC/ ST/
PH)

DOB
(dd/mm/yy
yy)

Name
of
Degre
e

Subject /
Branch

% of
marks /
CGPA
obtained
upto last
semeste
r

Rank
(if
any)

For students of Dual/Integrated ME/MTech Degree :

Name of
Candidate

Categor
y (UR/
OBC/
SC/ ST/
PH)

DOB
(dd/mm/yy
yy)

BE / BTech
Subject
/
Branch

%
Mark
s/
CGPA

19.

Dual/Integrate
d ME/MTech
Subject
/
Branch

% of
marks/
CGPA
obtaine
d upto
last
semest
er

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. If at any time, I am found to have concealed/ distorted any
material information, my appointment shall be liable to summary
termination without notice. I will, if and when required after joining DRDO,
take up duty in the discharge of government assignments anywhere in India.

Place:
Date:
(Signature of Candidate)
Counter signed
The above information is correct and has been verified.

Rank
(if
any)

Place :
Signature
OIC Training &
Placement cell
Date :