Application Form

2/28/15 Recruitment Portal https://www.bheljhs.co.in/apps/recruitement/print_cand_det.php 1/3 Bharat Heavy Electricals Limited, Jhansi [U.P.] Online Recruitment Application System Candidate Application Form Trade Apprentice Engagement 2015-16 under the Apprentice Act,1961 Personal Details Registration No 1015FT3480 Photo Registration Date 28-FEB-15 Candidate Name YASHPAL SINGH Father's Name SATGURU SARAN Date of Birth 01-JUL-95 Age as on 01-MAR-15 19 Yrs 8 Mths 0 Days Registered Email Id [email protected] Signature Category Other Backward Caste (OBC) Gender Male Trade Applied For Fitter Ward of Deceased Ermployee No Religion Hindu Nationality Indian Are you Physically Disabled No Correspondance Address 20,ganga enclave phase-1 near basera dayal bagh agra ( uttar pradesh) - 282005 Permanent Address 20,ganga enclave phase-1 near basera dayal bagh agra (uttar pradesh) - 282005 Mobile No 8899591847 Telephone No - Relation with Regular / deceased Employee of BHEL Jhansi No Employement Exchange details Name : Agra Reg No : 1015FT3480 Reg date : 28-FEB-15 Qualification Details SN Examination Subjects Board / University / Institute Period (in Yrs) Passing Year Result Type Coversion Factor Max marks Marks/Grade obtained Percent 1 HSC/10th math, science u.p board 1 2010 Percentage 600 338 56.33 2 SSC/12th 3 ITI(*Only NCVT) Fitter D.E.I board 1 2011 CGPA 9.5 8.6 81.70 Declaration I hereby declare that all the information given above are true to the best of my knowledge. I have all mentioned documents in support of Date of Birth, education, technical qualification, caste, Employment Exchange Registration No. etc. , which can be produced in original on demand. I have read the advertisement fully and agree to abide by all the rules and regulations of BHEL in case of my selection as apprentice. I haven’t undergone/ undergoing any apprenticeship Under the Apprentice Act, 1961.Further, in case of any wrong declaration and statement in this online format my candidature for Apprenticeship could be refused, rejected or rescinded at any point of time. Date : 28-Feb-2015 Signature _________________________ (YASHPAL SINGH)

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Application Form

Transcript of Application Form

2/28/15 Recruitment Portal

https://www.bheljhs.co.in/apps/recruitement/print_cand_det.php 1/3

Bharat Heavy Electricals Limited, Jhansi [U.P.]

Online Recruitment Application System

Candidate Application Form

Trade Apprent ice Engagement 2015-16 under the Apprent ice Act,1961

Personal Details

Registration No 1015FT 3480 Photo

Registration Date 28-FEB-15

Candidate Name YASHPAL SINGH

Father's Name SATGURU SARAN

Date of Birth 01-JUL-95

Age as on 01-MAR-15 19 Yrs 8 Mths 0 Days

Registered Email Id [email protected] Signature

Category Other Backward Caste (OBC)

Gender Male

Trade Applied For Fitter

Ward of Deceased Ermployee No

Religion Hindu

Nationality Indian

Are you Physically Disabled No

Correspondance Address 20,ganga enclave phase-1

near basera dayal bagh agra ( uttar pradesh) - 282005

Permanent Address 20,ganga enclave phase-1

near basera dayal bagh agra (uttar pradesh) - 282005

Mobile No 8899591847

Telephone No -

Relation with Regular / deceased Employee of BHEL Jhansi

No

Employement Exchange details Name : Agra Reg No : 1015FT3480 Reg date : 28-FEB-15

Qualif icat ion Details

SN Exa mina tio n Sub je cts Bo a rd / Unive rs ity / Ins titutePe rio d(in Yrs)

Pa ss ingYe a r

Re sultT yp e

Co ve rs io nFa cto r

Ma xma rks

Ma rks/Gra d eo b ta ine d

Pe rce nt

1 HSC/10th math, science u.p board 1 2010 Percentage 600 338 56.33

2 SSC/12th

3 ITI(*Only NCVT) Fitter D.E.I board 1 2011 CGPA 9.5 8.6 81.70

Declarat ion

I hereby declare that all the information given above are true to the best of my knowledge. I have all mentioned documents in support of Date of Birth, education, technical

qualification, caste, Employment Exchange Registration No. etc. , which can be produced in original on demand. I have read the advertisement fully and agree to abide by all the

rules and regulations of BHEL in case of my selection as apprentice. I havent undergone/ undergoing any apprenticeship Under the Apprentice Act, 1961.Further, in case of any

wrong declaration and statement in this online format my candidature for Apprenticeship could be refused, rejected or rescinded at any point of time.

Da te : 28-Fe b -2015

Sig na ture

_________________________(YASHPAL SINGH)
2/28/15 Recruitment Portal

https://www.bheljhs.co.in/apps/recruitement/print_cand_det.php 2/3

Document Enclosures Checklist ( Put Tick in box )

1. Re g is tra tio n No Slip

2. Ca te g o ry Ce rtifica te

3. HSC / 10th Ce rtifica te

4. SSC / 12th Ce rtifica te

5. IT I Ce rtifica te

6. Ce rtifica te o f Phys ica lly D isa b lity

Sig na ture

_________________________(YASHPAL SINGH)

Print Back
2/28/15 Recruitment Portal

https://www.bheljhs.co.in/apps/recruitement/print_cand_det.php 3/3

Cut and Paste following address on your own A4 size Envelope

(Application for Trade Apprentice Recruitment 2015-16 under the Apprentice Act-1961)

[ 1015FT3480 | Fitter ]

To,

Executive (HR),

Recruitment Cell,

Human Resource Department,

Administrative Building,

Bharat Heavy Electricals Limited,

Jhansi, Uttar Pradesh - 284120

From,

YASHPAL SINGH

20,ganga enclave phase-1

near basera

dayal bagh

agra , uttar pradesh - 282005