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BHARAT HEAVY ELECTRICALS LTD.Paste self

attested

recent

passport size

photograph

Power Sec tor: Projec t Enginee ring Manag ement

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NOIDA-201301 (UP)APPLICATION FOR THE POST OF DRAUGHTSMAN (CIVIL)

1. Na me (IN BLOCK LETTERS)

2. Fathe r`s / Husba nd`s Nam e

3. Date of BirthDay Month Yea r

4. Age as on 1st October 2009

Yea rs Months Days

5. Gend er :

Plea se Tick () Male Fem ale6. Religion:

7. Permanent Add ress Contac t / Mailing Add ress

Phone No. (w ith STD Cod e)

Mob ile No.:

City

State:

Phone No (with STD Cod e):

Email ID:8. Caste/ Categ ory Please tick ()

Gen OBC (Non-Creamy Layer) SC ST

9. Are you a Person Physically

Challenge d? Please tick () if yes,nature of handicap & perc entage of

disability.

Yes No

Loc om oto r Disability: ______ %ag e

Hea ring imp aired Hea ring Loss: ____ de c ibe ls

10. Are you an Ex-servicem an:

Plea se Tick ()If yes, Service Period in Defenc e :

Yes No

From_________________ To______________11. In c ase of BHEL Emp loye e wards/ spo use of Serving/ Supe rannua ted / Decea sed Employee. Put a

tic k () ma rk in the app ropriate b ox.Serving Retired

Dece ased Dea th during Service Dea th after Service

If yes, give the staff num be r of BHEL Emp loyee

12. Lang uage Preference for Written

Test:

Put a tick () mark.Hindi English

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n:13. Details of Educational Qua lificatio

Sl.

No

Examina tion Passed Yea r of

Passing

Name of Board/

University

Subjec t Max

Marks

Marks

Obtained

% of

Marks

1. High School

2. ITI

3. App rentic eship/ NAC

14. Any other Add itiona l Qualifica tionQua lifica tion Duration Full Time/

Part Time/

Correspondence

Specialization Percentage

of Marks

Month & Yea r of

Passing

From To

15. Comp uter Knowledge :___ _____________________________________________________

__________________________________________________________________________

16. Experienc e deta ils (Starting with present em ploym ent) :

No Organization

Position Held From To and

sponsibilities

_________________

Sl. Nam e of the Nature of duties

re

17. eta ils of Dema nd Draft:am e of Bank D No. D Date mo unt (Rs)

D

N D D A

DECLARATION

tion p roc ess, my c andida ture/ selection ca n be

anc elled, without assigning a ny rea son therefor.

lace: ________________ Signa ture of the Ca nd idate

ate :_________________

I hereby dec lare that a ll statements/ enclosed doc uments submitted by me are true a nd c orrec t to

the best of my knowledge and belief. I understand that in the event of any information being found

incorrect a t any stage during / after the selec

c

P

D

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[To be subm itted by OBC (Non-Crea my Layer]

I, _______________________ son/ daug hter of Shri _________________________________ resident of

villa ge/ town/ c ity _______________________ Distric t ______________________. Sta te ________________,

hereby declare that I belong to the ______________ community which is recognized as a backward

c lass by the Government o f India for the purpose o f reservation in services as per orde rs contained in

Depa rtment o f Personne l and Training Offic e M em orand um No. 36012/22/93-Est(SCT) d ated

08.09.1993. It is also dec lared tha t I do no t belong to pe rsons/sec tions (Creamy Lay er) mentioned in

Column 3 of the schedule to the above referred office memorandum dated 08.09.1993. and its

subseq uent revision through OM No.36033/ 3/ 2004-Estt (Res) da ted 09.03.2004]

Sig na ture of Cand id ate : __________________________________________________________________

Na me of the Cand id ate : __________________________________________________________________

Fathers Na me: __________________________________________________________________

Address: _________________________________________________________________

__________________________________________________________________

Place:

Date:

SELF UNDERTAKING FOR OBC (NON CREAMY LAYER) CANDIDATES