ONLINE APPLICATION FORM

DRDO ENTRY TEST - 2015

Advt. No. CEPTAM - 08

Cutoff/Closing Date - 8th Feb 2016

For Office Use Only :

ONLINE APPLICATION NUMBER : 80211023661
Printed On Date :28 / 01 / 2016
8. Nationality : INDIAN
9. Willing to serve in Remote Area # : NA
10. Gender :Male [ Y ] Female [ ]

1. POST NAME & CODE

TECH'A'-[0211-FITTER]
2. Preference For Exam City
I. 12-HYDERABAD
II. 25-VISAKHAPATNAM
III. 07-CHENNAI
3. Candidate's Name as Recorded in X Class Certificate
BALAJI BANDARU
4. Father's Name
VENKATESWARA RAO B
5. Mother's Name
MARY KUMARI B
6. Date of Birth (as recorded in X Class Certificate)
20 / 04 / 1989 , Age as on Cutoff Date 26Y, 9M, 18D
7. a) Category
[ ]
[ ]

Unreserved (UR)
Scheduled Tribe (ST)

[ ]
[Y]

Scheduled Caste (SC)

Other Backward Class
(OBC)

Ex-Service Man (ESM)

Meritorious Sports
Person (MSP)

[ ]
[ ]

[ ]

Persons with Disability (PWD)

[ ]

Orthopaedically
Handicapped (OH)
Visually Impaired (VI)

[ ]

Name : MR. BALAJI BANDARU

C/O : B VENKATESWARA RAO
D NO 4-132
DOKIPARRU
City/State: GUDLAVALLERU , ANDHRA PRADESH
Pincode: 521332 , Landline No:
b ) Permanent Address
Name : MR. BALAJI BANDARU
C/O
B VENKATESWARA RAO
D NO 4-132
DOKIPARRU
City/State: GUDLAVALLERU , ANDHRA PRADESH
Pincode: 521332 , Landline No:

7. b) Sub-Category
[ ]
[ ]

11. Contact Details (Note : All particulars given below in the

head should be maintained active till the end of recruitment
process)
a ) Address for Correspondence

[ ]

Govt. Servant (GS)

Widow/Divorcee

Hearing Impaired (HI)

c ) Mobile No
+91 - 9177501738
d ) Email
bandarubalaji1@gmail.com

12. a) Educational Qualifications (Must mention all completed/result awaited/appearing)

Qualification

X
XII
ITI
B.Sc
Diploma
Graduation
PostGrad.
OTHERS1
OTHERS2

Main Subjects / Trade

as mentioned on the
Certificate / Degree of
EQR
NA
FITTER

University / Board / Roll Year of

No.
Passing

Duration
of Course
(In years)

Maximum
Marks /
CGPA

Marks /
CGPA
Obtained

% of Marks
Secured

APBSE 0126220

2004

NA

600

342

57

NCVT 1616

2007

700

508

72

12. b) Higher Qualification [for post of STA 'B' / Tech 'A']

Have you Completed or pursuing M.E/M.TECH/PhD/M.Sc./B.Tech./B.E./AMIE/AMIETE etc.? YES [
Institute Name
Qualification
Status

] NO [ Y ]
Completion / Likely
Completion Date

13. Details of Exam Fee of Rs. 50/- Paid (If not exempted as per Govt. rules)
Payment Method
1161

Fee Amount
50.00

Payment Date
2016-01-28 09:44:02

Payment ID
47930678

Transaction ID Status
127170391
Processed

14. Employment Record in Govt./PSU/Autonomous Body etc. (If any)

Name of Organization

Post Held

Pay Scale /
Grade Pay

Period From Period to

Nature of Duties
(dd/mm/yyyy (dd/mm/yyyy Performed
)
)

15. Important Endorsements

a) (i) Type of ID Proof :
VOTER ID CARD
(ii) Height (cm) :
164 (5 Feet 4 Inch)
Identification Mark :
A MOLE ON THE LEFT PALM
(iii) Driving License : [for post of vehicle operator 'A' only]
(ii ) Two / Three Wheelers:
(i ) LMV :
(i ) HMV :

ID No.:
Weight (kg) :

XWM0293662
60

(b) For the serving defence personnel only, claiming benefit of Ex-Serviceman
Name of Unit

Rank

Date of
Joining

Date of
Discharge

CO Name

Contact NO.

16. Other relevant information (If any)

17. Declaration
I BALAJI BANDARU son/Daughter of VENKATESWARA RAO B hereby declare that
a) I have read and understood all the provisions mentioned in the advertisement and undertake to abide by them.
b) All the statements made in this application are true, complete, and correct to the best of my knowledge and belief.
c) I have submitted only one application for one Post in response to this advertisement.
d) I understand that in the event of any information being found suppressed, false or incorrect or any Ineligibility being detected before or
after the examination/recruitment my candidature/recruitment/appointment is liable to be cancelled.
18. Required at the time of document verification/trade test/interview, if shortlisted.
a) Left Hand Thumb Impression

b) Signature of Candidate

Place :
Date :

19. List Of Documents Uploaded

10th Class or Equivalent Certificate , EQR , Caste Certificate
Note : You are NOT REQUIRED to send print out of your application to the CEPTAM/DRDO at this time.
However, it is advised to keep this application form and copy of the advertisement for claiming travel concession from Railways, and also
for future references. CEPTAM does not undertake any scrutiny of application before examination and the eligibility is verified only after
examination. Accordingly, mere allowing the candidates to appear in the examination will not be construed as a ground of being eligible for
the post applied.
# for details, read CEPTAM-08 advertisement
ONLINE APPLICATION NUMBER : 80211023661

, Printed On Date :28 / 01 / 2016