APPLICATION FORMAT FOR DIPLOMA TRAINEE(ELECTRICAL) / JR. TECH.

TRAINEE- ELECTRICAL
IN POWERGRID
(USE CAPITAL LETTERS ONLY)
Affix self-attested
(DON’T ATTACH ANY DOCUMENTS EXCEPT BANK DRAFT AND / OR CASTE / PH CERTIFICATE )
(To be sent by Ordi nary Post only) latest Passport si ze

APLLICATION NO.(FOR OFFICIAL USE) Photographh

1 APPLICATION FOR THE POST OF POST CODE

2 NAME

3 FATHER/HUSBAND'S NAME

4 ADDRESS FOR
COMMUNICATION

State :

Pincode: Contact No.

5 STATE OF DOMICILE 6 SEX(MALE/FEMALE) M/F

7 DATE OF BIRTH Date Month Year

D D M M Y Y Y Y

8 CATEGORY AND CATEGORY CODE

CATEGORY : CATEGORY CODE:

(Gen - 1, SC-2, ST- 3, OBC-NCL- 4, PH- Gen- 5, PH-SC - 6, PH- ST- 7, PH- OBC-NCL - 8)

9 QUALIFICATION (DIPLOM A/ ITI)

10 DISCIPLINE IN DIPLOM A IN ENGG. / ITI

11 YEAR OF PASS 12 PERCENTAGE OF M ARKS .

13 INSTITUTE

14 BOARD

15 EMPLOYMENT EXCH. REGD. DETAILS (IF ANY)

EMPLOYMENT EXCH. REGD. NO.
EMPLOYMENT EXCH. REGD. NO.

16 BANK DRAFT DETAILS Rs.

DD NO. DATE BANK

D D M M Y Y

I CERTIFY THAT THE INFORMATION FURNISHED ABOVE IS TRUE .

DATE : (SIGNATURE OF CANDIDATE)