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PC Application Prelims 4046397

This document is an online application form for police recruitment in Andhra Pradesh. It collects personal details like name, date of birth, qualifications, community, contact details, preferences for test centers and posts from applicants. It also asks if the applicant qualifies for any age relaxations under different categories. At the end, applicants have to accept terms, certify that information provided is correct and note that hall tickets for examination will be available for download.

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vinaykumarteacher123
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76 views

PC Application Prelims 4046397

This document is an online application form for police recruitment in Andhra Pradesh. It collects personal details like name, date of birth, qualifications, community, contact details, preferences for test centers and posts from applicants. It also asks if the applicant qualifies for any age relaxations under different categories. At the end, applicants have to accept terms, certify that information provided is correct and note that hall tickets for examination will be available for download.

Uploaded by

vinaykumarteacher123
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
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STATE LEVEL POLICE RECRUITMENT BOARD, ANDHRA PRADESH

STAGE I ONLINE APPLICATION FORM


ONLINE APPLICATION FORM FOR THE POSTS OF SCT PC (CIVIL) (MEN & WOMEN): POST CODE NO. 21,
SCT PC (APSP) (MEN): POST CODE NO. 23,
VIDE NOTIFICATION RC.NO. 161/SLPRB/RECT.2/2022, DT. 28.11.2022

1. Name (As per SSC / Equivalent certificate) : NAGELLA VINAYKUMAR


2. Father's/ Husband's Name : NAGELLA SANKARAIAH
Preserve the REGISTRATION NUMBER
3. Mother's Name : NAGELLA RAMANAMMA
for all your future correspondence.
4. Gender : Male
5. Date of Birth : 15-06-1997
(As per SSC/Equivalent certificate) 4046397
6. (a) SSC/Equivalent Roll No. : 1219113343
(b) Year of Passing : 2012 11.
7. Upload Certificate (SSC or Equivalent) : Uploaded
8. Educational Qualification : B.A.
9. Community : BC-B
10. Upload Community Certificate : Uploaded
(For BC, SC and ST)
13. Do you belong to EWS Category ? : No

14.
Upload EWS Certificate : ---
(For OC)
15. Do you belong to Ex-Servicemen ? : No
Ex-Servicemen Joining Date : ---
Ex-Servicemen Discharge Date / Likely Date
of Discharge
: ---
16. ldentificaton Marks : A BLACK MOLE ON RIGHT JAW
(As per SSC / Equivalent certificate)
A BLACK MOLE ON RIGHT
:
FOREARM
17. Mobile No. : 6302377500 12.
vinaykumarteacher123@gmai
18. E-mail id :
l.com
19. (a) Do you have Aadhaar Card ? : Yes
(b) lf yes, please mention number : 362715976769
20. What is your preferred medium : Telugu
of Examination ?
21. Which is your prefered place for 1st : GUDUR
writing Preliminary written test ? 2nd : TIRUPATI
(SLPRB, AP reserves the Right to
include New Test Centres, if 3rd : KAVALI
necessary)
22. Post Preferences as per notification 1st : 21 - SCT PC (Civil) (Men &
Women)
2nd : 23 - SCT PC (APSP) (Men)
23. Which is your preferred place for 1st : Chittoor
appearing in PMT / PET after you
have qualified in Preliminary written 2nd : SPS Nellore
Examination ?
24. Are you a Local of State of Andhra : Yes
Pradesh ?
a) lf yes, which is your Local District ? : Chittoor
b) lf No, which State/UT you belong to ? : ---
25. Are you claiming benefit of age relaxation ?
(Please go through the Notificaiton)
: Yes
If yes, Please specify the applicable
category.
a) BC : Yes b) SC : No
c) ST/ABOST : No d) AP Government Employee : No
e) Ex-Servicemen : No f) NCC Instructor : No
g) AP State Census Department : No h) Andhra Pradesh Home Guard : No
i) Widow / Divorced / Judicially : No j) EWS Category
Separated Women
: No
26. As per Rule 3 (G) of GO Ms. No. 97 dated 01.05.2006 and amendments there on, and as mentioned in Notification at Para No. 27,
the candidates falling under certain categories shall be disqualified for recruitment. (Please go through the Notification)
Do you come under those : No
categories ?
If yes, please note that you are not
eligible for recruitment.

27. Address for Communication : 2-6 YELLAMPALLI, YELLAMPALLI, Chittoor, SRIKALAHASTI, 517620
28. Fee Paid through : Payment Gateway Transaction Id : YUR31598482800 Fee : 300
Certified that I have read, understood and accept all the Terms and conditions of the Notification. I undertake Complete responsibility that I have
submitted correct information to the best of my knowledge and belief.
Note: Please download Hall Ticket to have access to the Examination Centre. The Hall Tickets will be available for download from the website 14
days prior to the Date of Examination.

Date : 09-01-2023 06:59:36

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