APPLICATION FORMAT FOR PROCES TECHNICIAN GRADE-7

Application No. (For office use)

BHARAT PETROLEUM CORPORATION LTD

Mumbai Refinery

Affix recent Passport size Photograph here

APPLICATION FORMAT
[ Put a tick ( ) mark in the appropriate box ] 1. 2. 3. 5. 6. 7. Post applied for Name of the candidate (In Block letters) PROCESS TECHNICIAN GR-7

Sex:

4. Marital Status: Married / Unmarried Male / Female a) Age (Yrs. Completed) b)Date Of Birth DD MM YYYY as on 01/03/2012 : Fathers name : a) Domicile Status: Mother Tongue : b) Category (Put a () tick mark in the appropriate box)* OBC Percentage of (NonGEN SC ST PWD OH / VH creamy Disability:
layer)

8.

Correspondence Address:

9.

Permanent Address:

10.

Pin Code Nearest Railway Station

Pin Code 11. 12 Contact No. e-mail ID

13. QUALIFICATION I. DIPLOMA- CHEMICAL ENGG : YES / NO ( FULL TIME / PART TIME / CORRESPONDENCE )

II.
III. IV

PERCENTAGE: _______________ ( 1ST CLASS / 2ND CLASS ) INSTITUTE NAME: ANY OTHER CERTIFICATE/QUALIFICATION: UNIVERSITY :

(Please attach photocopies of all Marklists/certificates) 14. YEARS OF EXPERIENCE : II.Previous Experience (In chronological order) (Attach proof ) Duration (exact dates to be given) Name of Organisation Posts held From To

Industry Please specify whether refining/ petroleum/ chemical/petrochemical/ fertilizer industry etc

I hereby declare that all the statements made in this application are true and complete to the best of my knowledge. If at any stage of the selection process, the above statements are found to be false or incomplete, I understand that my candidature will stand cancelled. Date : ____________________ Signature : ___________________________

Attach photocopies of certificates mentioned above or any other testimonials in your possessions Those employed in Govt. Dept. / Public Sector Undertakings should apply through proper channel. Interested candidates may submit their applications by post along with a latest passport size photographs, giving all personal details with testimonials and supporting documents, in sealed envelope superscribed with (Post Process Technicians Gr-7) to; Sr. Manager (HR), Bharat Petroleum Corporation Ltd., Mumbai Refinery, Mahul , Mumbai 400 074. Last date for receipt of completed application is 31.03.2012