ANNEXURE-I BIO-DATA FORM Advt.No.:BDL/C-P&A/PLG.&ED./2011-4 Name of the post applied for: Online Registration No.

: In case of working in Govt/Quasi-Govt Organisations/PSU, whether applied through proper channel: Yes No Not applicable

In case of Yes, Please attach a copy of the forwarding letter of the employer or NOC to be produced at the time of Interview 1 2 3 Name of the Candidate (In capital letters) Date of Birth (DD/MM/YYYY) Fathers Name & Occupation

Permanent Address

Present Address (for any correspondence) Phone No./Mobile No. E-Mail ID (Mandatory) Nationality Religion Place of Birth & State Marital Status Specify which category you belongs to (tick) Are you a person with disability (if yes, pl. specify) Are you an Ex-Servicemen (if yes, pl. specify no. of years of service) Single/Married GEN / OBC / SC / ST Yes No Visually/Hearing/Orthopaedically

6 7 8 9 10 11 12 13

14

Yes

No

No. of years:

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15. Educational Qualifications (Declare all the qualifications, which you posses and pursuing) : S.No Qualification (SSC onwards) Subjects University/ Institution Year of passing %age of Marks Duration of the course

I hereby declare that I do not posses any other qualifications and also not pursuing any other course. I may be terminated without notice if Management found that I have concealed any higher qualification, which I have possessed before joining the Company and also pursuing higher qualification at the time of joining the Company. 16. Experience details (Start from Present Employer) : S.No Full Address of Office/Firm or Institution Central/ State/ PSU/ Private Desgn. of post held Scale of Pay & Gross Pay Period of service From To Reasons for leaving

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16. Experience details starting from the present Company (Pl. attach additional sheet, if required) :

S.No.

Nature of Duties

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Any of your relative working/worked in BDL (tick) (if yes, specify details) Present Pay particulars of the candidate applying for the post (if any) Scale of Pay Basic DA HRA Any other (Pl. Specify) (Enclose latest payslip Have you ever attended for Interview for any post in BDL (if yes, pl. specify)

Yes

No

19

Yes

No

Name of the post: Date when attended:

DECLARATION I hereby declare that the information stated above by me is true, complete to the best of my knowledge and belief. In case, the information stated above by me is found to be false or incorrect, my candidature / appointment may be considered terminated without any notice.

Date: Place:

Signature: Name of the Candidate:

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