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Middle Initial in Application Form

This document is an application for a training program at BARC. It contains personal details of the applicant such as name, date of birth, contact information, category, and family details. It also includes academic details of the applicant such as percentages and years of passing for their undergraduate degree, Class 12th, and Class 10th. The applicant's undergraduate degree is an Integrated M.Tech in Electrical Engineering from West Bengal University of Technology. For the screening process, the applicant has selected the online test screening channel and chosen Kolkata as their test center choice.

Uploaded by

Rajdeep Bhadra
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
89 views4 pages

Middle Initial in Application Form

This document is an application for a training program at BARC. It contains personal details of the applicant such as name, date of birth, contact information, category, and family details. It also includes academic details of the applicant such as percentages and years of passing for their undergraduate degree, Class 12th, and Class 10th. The applicant's undergraduate degree is an Integrated M.Tech in Electrical Engineering from West Bengal University of Technology. For the screening process, the applicant has selected the online test screening channel and chosen Kolkata as their test center choice.

Uploaded by

Rajdeep Bhadra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

2/8/2017 ViewApplication

ApplicationDetails(OCES/DGFS2017)

PersonalInformation
RegistationNo: 17EE1063434
(FirstName) (Middle/Initial) (LastName)

Name:
PALASH MONDAL
(Asappearingin10thClassboardorequivalentmarksheet)
(FirstName) (Middle/Initial) (LastName)
Mother'sName: JOYDURGA MONDAL
DateofBirth: 1041990
(FirstName) (Middle/Initial) (LastName)
Latergivennames:
(ifany)
(FirstName) (Middle/Initial) (LastName)

Father'sName: NITAI MONDAL

Gender: Male

EmailId: palashmondal304@[Link]

MobileNo.: 9749023770
Category: SC

Caste/Tribe: NAMASHUDRA
Areyouadependentofthose
NO
whodiedintheriotsof1984(Dep1984)?

WereyouphysicallydomiciledinKashmir
DivisionofJammu&KashmirState NO
from01/01/1980to31/12/1989(DomKashmir)?

Areyouadependantofdefensepersonnelkilledinaction(DODPKIA)? NO

AreYouPhysicallychallenged? NO

CommunicationDetails
PermanentAddress AddressforCorrespondence
VILL
AddressLine1: AddressLine1: VILLUMACHARANPUR
UMACHARANPUR
[Link]
AddressLine2: AddressLine2: [Link]
SALKUMAR

AddressLine3: [Link] AddressLine3: [Link]


AddressLine4: AddressLine4:
City: FALAKATA City: FALAKATA
District: ALIPURDUAR District: ALIPURDUAR
State: WESTBENGAL State: WESTBENGAL
Pincode: 735220 Pincode: 735220

Landlineno: Landlineno:

Photograph:

Signature:

[Link] 1/4
2/8/2017 ViewApplication


AcademicBackground

DetailsofUGDegree

QualifyingDegree: [Link]

QualifyingDegreeSubject: ElectricalEngineering

University: WestBengalUniversityofTechnology,Kolkata

KALYANIGOVERNMENTENGINEERING
College/InstituteName:
COLLEGE

AddressLine1: KALYANI

AddressLine2: NA

AddressLine3: NA

AddressLine4: NA

City: KALYANI

State: WESTBENGAL

Pincode: 741235

Yearofpassing: 2016

Aggregate%: 75.40

Predegreequalification: 12th

DetailsofClass12th
Board/University: WESTBENGALCOUNCILOFHIGHERSECONDARYEDUCATION
School/College: FALAKATAHIGHSCHOOL
City/Taluk: FALAKATA

State: WESTBENGAL
Yearofpassing: 2009

Aggregate%: 72

DetailsofClass10th
Board/University: WESTBENGALBOARDOFSECONDARYEDUCATION
School/College: MADARIHATHIGHSCHOOL

City/Taluk: MADARIHAT
State: WESTBENGAL
Yearofpassing: 2007
Aggregate%: 81.63

DetailsofanyotherAdditionalQualification

Nameofqualification: NA

University/Institute: NA

Yearofpassing: NA

Aggregate%: NA

[Link] 2/4
2/8/2017 ViewApplication

ScreeningChannel
[Link]
channel.
Channelthroughwhichyouwishtobeconsidered: OnlineTest:YES GATEScore:NO

OnlineTestMode
[Link].

TestCentreChoices

Choice Choice Choice


Kolkata Durgapur Raipur
1: 2: 3:

MiscellaneousInformation

YearsappliedforBARCTrainingSchoolbefore: NA

YearsappearedforinterviewtoBARCTrainingSchool: NA

[Link] 3/4
2/8/2017 ViewApplication
YourIPAddressis:[Link]
Print Home

[Link] 4/4

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