Confidential E-Application Form

Carborundum Universal Limited Chennai-600 001

Position applied for Name Contact No E-Mail Father's name / occupation Date of Birth Place of Birth Height in cms Blood Group Male / Female Single / Married / Others Nationality Caste Religion PAN NUMBER Address (Permanent) Address ( Present)

Mechanical enggineer Neha sharma Landline : 0121-2623029 Mobile: 09412321650

neha_srma2007@yahoo.com Mr.Ram Prakash Sharma 21-01-1991 Meerut 170.68 B -ve female single indian General Hindu Weight (in Kgs)=52

C-40 AMAN VIHAR COLONY MAWANA ROAD ,MEERUT(U.P.) G-702 GAMMA –II GR. NOIDA G.B. NAGAR

CUMI - 'an Equal Opportunity Employer'

Confidential E-Application Form

Carborundum Universal Limited Chennai-600 001
Emergency Contact No. and name & Relationship of the person Dependants : Name Mr. Ram prakash 1. sharma 2. Mrs.Rani Sharma 3. 4. Education Qualification Course 1. High school 2. 3. Diploma B.tech

09818029886,& Mr. Harkesh Sharma (mamaji)

Relationship father mother

Age 48 44

Occupation service housewife

Institution R.G. inter college,Meer ut Govt. polytechnic , Moradabad N.I.E.T

From / To 2004 2005 2005 2008 2008 2011

Stream

Grade 69.2% 80.5% 81%

Mech. Mech. Y

Are you prepared to work or to be transferred anywhere in India? (Y/N) If no, Please given reasons :

Membership of Professional Bodies/Position held: N/A Significant Achievements, if any : Won first prize to be a college topper in2008 Won first prize in badminton at college level in2008 Won first prize to be a topper in 2010

Languages Known 1.Hindi

Read yes

Write yes

Speak yes

CUMI - 'an Equal Opportunity Employer'

Confidential E-Application Form

Carborundum Universal Limited Chennai-600 001
2. English 3. 4. Details of Training undergone Name of the training Programme 1.Four weeks 2.four weeks 3. yes yes yes

From June201 0 June200 9

to July201 0 July200 9

Conducted by GKN,Faridaba d BHEL,Haridwa r

Remarks Very good Very good

I declare that the particulars given are correct and I have not withheld any fact which may effect my application adversely (Y/N) : Y Date : 7-03-2011 Location : Chennai

SIGNATURE

CUMI - 'an Equal Opportunity Employer'

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