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Click to Print

Indian Oil Co po a ion Limi ed (A Go

e nmen of India Unde aking)

Applica ion fo m (Pe onal & Confiden ial)

Please take the print out of the application form in A4 si e portrait format onl

GATE Reg. # IndianOil Reg. # Da e Name Fa he ' Name EMail Id Da e of Bi h Mobile No. Ca ego Depa men al S a e of O igin Di c Applied Q alifica ion Ma k (%): Pa E ing Yea : e iceman ie Cen e

: EE6088364 :

272053
GHOSH

: 11/02/2012 : Mr. DEBAJYOTI : DILIP GHOSH : debaj oti.ghosh.87@gmail.com : 07/12/1987 : 9230216131 : Gen : No : West Bengal : EE-Electrical : Electrical Engineering (D 69.10 07/2010 : No : No : Kolkata : 660 , E BLOCK , J&K Domicile : No a ion : 4Y 00Mn)

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

Ph . Handicap In e Add e

BAGHAJATIN ,KOLKATA -West Bengal (700086 ) All the information given in this application form are true to the best of m knowledge and belief. If an of the information is found incorrect, m candidature ma be cancelled. Da e : Signa e:

CANDIDA E O PLEA E NO E: 1. Please note our Registration Number for future reference. . 2. Please sign and paste latest good qualit 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 photocop of this application form for our record and future reference. 4. Write our Email Id & Contact No.(preferabl Mobile) here, and ou are requested to retain this Email id and Mobile No. for atleast 6 months. :

Email Id:

Telephone/Mobile No.:

5. Please visit our website www.iocl.com regularl for further information.

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