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7/17/2016

PGVCLPRINTAPPLICATIONFORMFORTHEPOSTOFVIDYUTSAHAYAK(JUNIORENGINEERELECTRICAL)

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PaschimGujaratVijCompanyLimited
AnISO9001:2008CertifiedCompany

APPLICATIONFORMFORTHEPOSTOFVIDYUTSAHAYAK(JUNIORENGINEERELECTRICAL)



ApplicationNo
2107208
ApplicationRegistrationDate
17072016
(RegistrationID)



ApplicantName

DHAVALRAMANBHAIPATEL


MailingAddressandPersonalDetails

Correspondence PlotNo4972,Sector7B,Gandhinagar,382007,
Address
Gujarat

PhoneNo

MobileNo 7698444407

City

Gandhinagar

State

Gujarat

MaritalStatus

Married

PHStatus

PinCode

382007

No

EMail

dhaval_career@rediffmail.com

BirthDate

14011983

Gender

MALE

GENERAL

Caste

DependentofRetiredEmployeeoftheCompany No
ExArmedForcePersonnel No

DepartmentalCandidate:
No
EducationalQualification[GRADUATIONDEGREE]TotalofLastTwoSemsMARKS
Nameof
Graduation
Degree

Sr.
No

BTech(Elec)

NameofCollegeandUniversity

Yearof
Passing

GradeSystem

Division/
Grade//%age
Obtained

Nationalinstituteoftechnologyrourkela
2004
PERCENTAGE 68.285
nitrourkeladeemeduniversity
RecruitmentFeesPaymentDetails

PaymentMode

PaymentRefNo.

AmountPaid(Rs.)

PaymentDate

ONLINE

494808

500

17072016

Equivalent
(%)
00.00Format

68.28

DocumentsandUndertaking
Iherebysubmitphotocopiesofthecertificatesasmentionedinadvertisement.
Undertaking:Icertifythatthedetailsmentionedintheapplicationarecompleteandcorrect.Ifurtherundertakethatif
any information given herein above is proved wrong then I am liable for being dismissed from the service of the
Company. I also certify that, no Criminal Proceeding are initiated / Pending against me and I have never been
convictedbyanyCourtofLaw.
ApplicationConfirmationNo

170721072081448

ApplicationConfirmationDate

2016071714:48:15

Date:
Place:

(SignatureofApplicant)

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