Affix recent passport size colour photograph

1. Name of the POST applied for: 2.Name of the candidate in BLOCK LETTERS: ... 3. Fathers Name 4. Date of birth 6. Gender 8. Religion (Please specify) : .................... : 5. Age as on 01.05.2013 ...yrs ..mths : 7.Nationality : .. ........ : 9. Marital Status: .

10. Category (GENERAL/OBC/SC/ST/PWD):.......... If PWD, indicate whether VH / HH / OH and extent of disability in percentage 11.Address: PERMANENT . . . CORRESPONDENCE*

. PH.NO: PH.NO. Email address: *Correspondence will be sent to this address 12.. QUALIFICATION: Name of Percen Degree tage/ Class Qualification Institute/ University (B.E / CGPA secured B.Tech, etc) * Engineering Degree

Year of passing

Branch of study

Post Graduate Degree Others

* Method of CGPA conversion to percentage, as mentioned in marks sheets, should be enclosed. Candidates who are in final semester should mention the aggregate percentage or equivalent CGPA, upto 3rd Semester.

13. POST QUALIFICATION WORK EXPERIENCE (if any), beginning with the current job : Name of the CTC organization Tenure of service Designation (in Area of work (briefly) (Indicate if lakhs) PSU/ Govt) From To (dd/mm/yy) (dd/mm/yy)

14. Please give particulars of your relative/s employed in BEL, if any: Name Relationship Designation Department

Unit

15. If you have appeared for any previous selection for appointment in BEL, please furnish details of the same: ................. 16. Demand Draft No & Amount........................................... 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: Enclosures: 1)SSLC/Matriculation Certificate 2) Final Degree Certificate of B E/B Tech 3)Semester wise marks cards of ME / M.Tech 4) Final ME /M Tech Degree Certificate 5) Experience Certificates from previous employers (if any) 6) Caste / Disability certificate in case of ST / OBC/ PWD, in the approved format applicable to claim reservation. The candidature of those who do not produce the required format will be considered under the General category.