Affix recent passport

size colour
photograph signed by
the candidate.
Do not use stapler or

POST APPLIED FOR & JOB CODE: .......

1. Name of the candidate in full
(As per SSLC/SSC Certificate) :......................

2. Fathers Name

: ..........

3. Age / Date of birth

: ..........................................................

4. Gender :

MALE

FEMALE

6. Religion (Please specify)

7. Category:

5. Nationality:.....................................

: ....................................................................................................

GENERAL

OBC

SC

8. Whether Physically Challenged: YES

NO

9. If yes, mention the category of disability: VH

10. Marital Status: MARRIED

ST

OH

HH

UMMARRIED

11. Address:
PERMANENT

PH.NO.

CORRESPONDENCE

PH.NO:
Email address:

12. QUALIFICATION (From SSLC/SSC Onwards):

Qualification

Institute/ University

Percentage
/ Class
secured

Year of
passing

Subject/
Discipline

Method of CGPA conversion to Class should be enclosed

13. EXPERIENCE (Start with the Existing) (If required please attach separate sheet):
Name of the
organization
(indicate if
PSU/Govt)

Employment
details
From

To

Designation

Cost to
the
Company

Relevant experience
specific to the
requirement for the post
applied for

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

Name

Relationship

Designation

Department

Unit

15. Have you appeared for any previous selection for Appointment in BEL? If so, please
furnish details in brief:

16. Details of Application Fee:

Journal No

Amount

Date

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: