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21/02/2015

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APPLICATIONFORM

NOTE:PleaseNoteDownYourRegistrationNumberForFutureReference.Xerox
copiesof*CasteCertificate,Originalcertificateofprescribedqualificationorany
othercertificatesentseparatelyonalaterdateaftersubmissionofapplicationwill
notbeaccepted.
*Ifanyinformation,givenbelowfoundtobefalse/incorrectyouwillforfeittoclaim
refundoffee.
1.ApplicationregistrationNo.:51/0005506(E)
2.NotificationNo.
01/2015
3.Postappliedfor
A.F.MTRAINEE(ELECTRICAL)
4.Nameinfull
MEESALASAIRAM
5.Father'sName
MCHANDRASHEKARRAO
6.Sex:MALE7.DOB:22Apr19958.Caste:BCB
9.MailingAddress
H.No.:12452,ISLAMPURA
Street.:MANCHERIAL
Vil&PO:/MandalMANCHERIAL
District:ADILABADPINCODE:
504208
State:TELANGANA
NativeState:TELANGANA
10.EducationalQualifications:
ExamPassed
Degree

Qualification
DIPLOMA

11.Experienceinyears
12.Emp.Exc.Name&Reg.No.
13.Workinginandas
14.Hobbies:
15.AnyOtherInformation:

Tel:
Cell:8019478077
DDNO:971090
DDDATE:21Feb2015

Subject
ELECTRICAL&
ELECTRONICS

Local/NonLocal:LOCAL
Identification
Proof:AADHARCARD
IdentificationNo:89126923
2094
EmailID:
meesalasairam456@gmail.com

Universityandinstitution

%
Pass
marks Year

SBTET

90.80

2014

Dura
tion
3

0
:
LISTENINGTOMUSIC
NCC,BANDCWITHBGRADES

16.Iamenclosingherewithcopiesofrelevantcertificatesi)SSC(OR)equivalentcertificateinproofofdateofbirth.ii)
Permanent/Provisionalcertificateinproofofqualificationsiii)Marksmemoallyearwise/consolidatedmarks.iv)
Castecertificateissuedbycompetentauthorityv)Selfaddressedstampedenvelopevi)Localcandidaturecertificate.vii)
Onepassportsizephotographpinnedtothelefttopcorneroftheapplication.
17.(ForClaimingLocalCandidatureoneshouldinvariablysubmit4thto10thstudycertificatebeforeSSC.Forfurther
detailsvisitSCCLwebsite)
18.Ideclarethatalltheinformationgivenaboveistruetothebestofmyknowledge.Iunderstandthatifany
informationsubmittedbymeisprovedtobefalseatanystage,thedecisionofthemanagementwillbefinalandbinding
onme.Ifappointed,Iagreetoabidebytherulesandregulationsoftheorganization.
Place:HYDERABAD21/02/2015
Date:SignatureofApplicant
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