Affix recent passport Size colour photograph signed by the candidate. Do not use stapler or pin.

(GHAZIABAD UNIT)

NAME OF THE POST

: _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ _

1. Name of the candidate in full (As per SSLC/SSC Certificate): __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ _ 2. Father’s Name : _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ 3. Age / Date of birth : _ _ __ _ __ _ __ _ __ _ ___ _4. Gender : MALE/FEMALE 5. Nationality: _ _ __ _ __ _ __ _ __ _ __ _ 6. Religion (Please specify) : _ _ __ _ __ _ __ _ __ 7. Category : _ _ __ _ __ _ __ _ __ _ __ _ _(GENERAL/OBC/SC/ST/PWD) 8. E-Mail: _ _ __ _ __ _ __ _ __ _ __ _ _ 9. Mobile No. _ _ __ _ __ _ __ _ __ _ __ _ _ 10. Address: PERMANENT

Phone No.(With STD Code):

CORRESPONDENCE

Phone No.:

11. QUALIFICATION (From SSLC/SSC Onwards): Qualification Institute / University % of * Marks/ CGPA 10th Standard 12th Standard Graduation/ B.E/B.Tech Post Graduate/ M.E/M.Tech Other Higher Education/ Professional Qualification *Aggregate %age of all Semesters

Year of passing

Subject/ Discipline

12. EXPERIENCE (Start with the Existing employer) (If required please attach separate sheet): Name of the organization

Employment Details From

Designation

To

Cost to the Company

Area of work

13. Please give particulars of your relative employed in BEL, if any: Name

Relationship

Designation

Department

Unit

14. Have you appeared for any previous selection for Appointment in BEL? If so, please furnish details in brief: 15. SBI Reference No.: _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _

UNDERTAKING I affirm that the information given above is true and correct. I further undertake that, if at any stage, it is discovered that an attempt has been made by me to willfully conceal or misrepresent the facts stated above, my candidature may be summarily rejected or my employment terminated.

SIGNATURE OF THE CANDIDATE Date: Place: