POWER GRID CORPORATION OF INDIA LIMITED

(A Government of India Enterprise)

APPLICATION FORMAT FOR THE POST OF FIELD ENGINEER / FIELD SUPERVISOR (ON TEMPORARY CONTRACTUAL BASIS) FOR NOFN CONSULTANCY PROJECT IN SRTS-I
(Use Capital Letters only)
Diary No __________________________________________ (For office use) Post Applied Employment Exchange Registration No., if any Medium of screening Test, if required (Please tick) English Hindi

Personal Details
Name in full Fathers/ Husbands Name Date of Birth Marital Status State of domicile Religion PH *If PwD, Please specify category Minority Community Gender Nationality Category

Please Paste a Recently Taken Self Attested Photograph

Gen

SC

ST

OBC(NCL)

Yes* OH Yes* Yes*

No HH No No VH

* Percentage of disability PH Sub-category

*If yes, specify

Muslim Christian Sikh Buddhist Zoroastrians

Ex Serviceman *Service from

* if yes, date of discharge *Service to

In case you belong to SC/ST/OBC (NCL)/PwD / Ex-servicemen, attach attested copies of relevant certificate(s).

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POWER GRID CORPORATION OF INDIA LIMITED

(A Government of India Enterprise)

Contact Details
Address Mailing Permanent

Nearest Railway Station Tel No Email ID Mobile No

Qualification Details ( Enclose attested copies of certificates in support of your qualification)

Please fill from 10th onwards Sl. No Qualification Specialization Institute/ College and University Year (From To) % of Marks/ CGPA Division

Experience Details, if any ( Enclose attested copies of certificates in support of your experience)
Sl. No. Period of Employment From To Duration (Years and Month) Name of Organization and Type (Govt/PSU/Pvt) Position Held Pay Scale / Salary details (p.m.) Area and Nature of Duties

II

Attach separate sheet in same format in case the space above is not sufficient.

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POWER GRID CORPORATION OF INDIA LIMITED

(A Government of India Enterprise)

Bank Draft Details, if applicable

Name of the Bank Issuing Branch DD Number Date of Issue Amount (Rs.)

Do you suffer from any major ailment/ deformities (e.g. cancer, TB, etc.) * If yes, please give details ________________________________________________________ Have you ever been arrested/kept under detention/ bound by Police:

Yes *

No No No

Yes * Have you ever been prosecuted/ fined/ convicted or have any case pending in any court of law: Yes *
* If yes, please give details ________________________________________________________

I hereby declare that the above information furnished by me is true and correct to the best of my knowledge. If any information is found to be false/ incorrect, it will disqualify me for employment in POWERGRID.

Place Date

Signature Name

Enclosures: (Applications received without relevant documents shall not be considered) Documents SSC/10th 12th class certificate in support of Date of Birth Class Certificate Tick (), if enclosed

Diploma (Mark sheets and Pass Certificate) Graduation (Mark sheets and Degree certificate) Experience Certificate(s) Demand Draft Caste certificate [SC/ST/OBC(NCL)], if applicable PwD Certificate, if applicable Ex-servicemen discharge certificate, if applicable

Last Date for receipt of Application: 8th February 2013 Please send the application along with enclosures through Ordinary Post to: Chief Manager (HR) / HOP Power Grid Corporation of India Ltd. SRTS-I, Regional Headquarters, # 6-6-8/32 & 395 E, Kavadiguda Main Road Secunderabad 500 080, Andhra Pradesh

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