BHARAT PETROLEUM CORPORATION LIMITED

(A Govt. of India undertaking)

APPLICATION FOR EMPLOYMENT FORM
POST
.

Affix your
recent
passport size
photo here

DISCIPLINE :
.
PART A
1. Full Name :

__________________________________________________
(First)
(Middle)
(Surname)

2. Age (in years) as on 1.6.2016: ________ ______

3. Date of Birth(dd/mm/yyyy) : ______________
4. Category (SC/ST/OBC Non Creamy Layer/General) :
______________________________
5. Fathers / Mothers Occupation : Father ___________________________
Mother ___________________________
6. Particulars of siblings, if any 1._____________________________________
2.______________________________________
7. Mother Tongue : ____________________ Home town :
________________________
8. Nationality : ________________________Religion : ________________________
9. Address for communication :
10.

Permanent Address :

11.
12.

Landline telephone No :
E-mail id :

13.

If PWD, type of disability (OH/HH/VH) : ______ ;

Mobile No:
Alternate e-mail id :
% of

disability : ______
14.
Academic Qualifications (from 10th Standard onwards) :
Qualificat

Year of
passing

Specialisatio
n

Institute

% of marks
or

ion

equivalent
CGPA

10th Std
12th Std /
Diploma
Graduati
on Semester
wise

15.

Internship / Project / certification programs :

Organisation /
Institute Name

16.

Month & Year

Project Name

Detail of
internship /
project/certificati
on

Have you been ever interviewed in BPCL Before :

No. (if yes, please give details)

Period of working :______________________________
Designation :
________________________________
17.
Have you been convicted of any offence?

Yes /

Yes / No. (if

yes, please give details)

18.

Work Experience, if any :

Organisation

Designatio

Job Profile

Duration

19.

Extra Curricular activities & Interests :

Reasons for
leaving

List two personal reference (not relative or former employees) with

their occupations and addresses.

I hereby affirm that the information on this form is true.

Place : ______________________________
Date : _______________________________

Signature