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STEEL AUTHORITY OF INDIA LIMITED

Management Trainee - Technical -(ELECTRONICS & INSTRUMENTATION)
Provisional Registration Slip

1. Registration No.

: MT1403103109959

2. Applicant Name

: KOUSHIK DASGUPTA

3. Father's Name

: SAIBAL DASGUPTA

4. Date of Birth

: 26-03-1987

5. Gender

: Male

6. Address For Correspondence

A-04, SHILP BUNGALOW,NEAR- SAHYOG SOCIETY,

B/H- SHANTINAGAR,
: GORWA,
VADODARA, VADODARA,
GUJARAT-390016.

7. Category

: GEN

8. Are You a Minority Community?

: No

9. Are You a Ex-Service man ?

: No

10.Are You Physically Disabled?

: No

11.Are You a Departmental Candidate

: No

12.Educational Qualification

: B.Tech(ELECTRONICS & INSTRUMENTATION)

13.E-Mail ID

: koushikdasgupta.plc@gmail.com

14.Mobile No

: 7048339488

15.Choice of Centre (City1)

: Baroda

Payment Details :
DU Code

Payment Mode

Date of Payment

Payment Status

Amount

DU12078285

NETBANKING

26-02-2015

Confirmed

500

Please Keep a copy of the Registration Slip as the same can be asked at any stage of the recruitment process.

Declaration :
I hereby declare that I agree with all the terms and conditions given in the advertisement and that the above
information given by me is correct. I understand that false statement and/or suppression of any material fact in this application will be
considered sufficient cause for withdrawal of my candidature/appointment offer/dismissal without notice.

Applicant signature
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