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Indian Oil Corporation Limited (A Government of India Undertaking)
Application form (Personal & Confidential)
Please take the print out of the application form in A4 size portrait format only

GATE Reg. # IndianOil Reg. # Date Name Father's Name EMail Id Date of Birth Mobile No. Category Departmental State of Origin Disc Applied Qualification Marks (%): Passing Year: Exserviceman Phy. Handicap Interview Centre Address

: ME7021566 : : : : : : : : : :


06/01/2012 Mr. SANTHOSH SADAGOPAL SADAGOPAL 21/10/1984 9150083111 OBC(NCL) VETTUVA GOUNDER No Tamil Nadu ME-Mechanical(Excluding Production/Manufacturing/Industrial : Engg.) : Mechanical Engineering (Duration : 4Yr0Mn) 71.22 05/2007 : No : No : Chennai : 163 JAWAHAR BAZAR , ARASU XEROX , ,KARUR -Tamil Nadu (639001 ) J&K Domicile : No

Paste your recent self attested Passport size photograph and it should be the same as submitted along with GATE Application form.

All the information given in this application form are true to the best of my knowledge and belief. If any of the information is found incorrect, my candidature may be cancelled. Date : Signature :

CANDIDATE TO PLEASE NOTE: 1. Please note your Registration Number for future reference. . 2. Please sign and paste latest good quality recent color photograph at the place provided. You are advised to retain an identical photograph for future use. 3. You are advised to take a photocopy of this application form for your record and future reference. 4. Write your Email Id & Contact No.(preferably Mobile) here, and you are requested to retain this Email id and Mobile No. for atleast 6 months. :

Email Id:

Telephone/Mobile No.:

5. Please visit our website regularly for further information.

1/6/2012 8:07:33 PM

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