Affix recent

passport size
colour
photograph

1. Job Code ……………………………….. Post applied for ……………………………………..

E-II GRADE E-III GRADE E-IV GRADE

2. Name of the candidate in BLOCK LETTERS: ……………………………………………………………..……….

3. Father’s Name: ……………………………………………………….……………………………………………..

4. Date of birth : ………………………….…… 5. Age as on 01.12.2017 ______Years______Months______Days

6. Gender: ………………………………… 7. Nationality: ………………………………..……………………..…

8. Marital Status: ………………………… 9. Religion: …………………………………………………………….

10. Category (GENERAL/OBC/SC/ST/PWD): ……………………………….……………………………………….

 Enclose certificate in the prescribed format
 If PWD, indicate whether VH/ HH / OH and extent of disability in percentage ………………………….….

11. Address:

PERMANENT CORRESPONDENCE

City: City:
State: State:
Pin Code: Pin Code:
Mobile No Mobile No

Mail ID* (In Capital Letters):

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12. QUALIFICATION:
Branch of study as
Percentage / Month &
Qualification Institute / University mentioned in the
Class Secured Year of passing
Degree certificate
__.__% M M

_____ CLASS Y Y Y Y

__.__% M M

_____ CLASS Y Y Y Y

__.__% M M

_____ CLASS Y Y Y Y

__.__% M M

______ CLASS Y Y Y Y

13. POST QUALIFICATION WORK EXPERIENCE (if any), beginning with the current job:
Name of the organization Tenure of service
CTC
(indicate if Public From To No of Years Designation
(in lakhs)
sector/Govt) (DD/MM/YY) (DD/MM/YY) & Months

Total No. of
Yrs &
Months

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14. Please give particulars of your relative/s employed in BEL, if any:
Name Relationship Designation Department Unit

15. If you have appeared for any previous selection for appointment in BEL, please furnish details of the same:
……………………………………………………………………….………………..……………………………….
……………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………

UNDERTAKING

I, affirm that the information given above is true and correct. I further undertake that, if at any stage, it is discovered
that any attempt has been made by me to willfully conceal or misrepresent the facts stated above, my candidature may
summarily be rejected or my employment terminated.

Date:
Place: SIGNATURE OF THE CANDIDATE

Enclosures: Tick the below mentioned photocopies of documents that has been enclosed along with the
application:

Sl No Documents Tick the box

1 A document as proof of date of birth
Semester wise marks cards of BE / B Tech. (Candidates who have completed bachelor’s
2
degree after Diploma have to enclose all the semester copies of diploma certificates also)
3 Semester wise marks cards/Grade card of ME / M Tech./ MS
4 BE / B Tech / ME / M Tech/ MS Degree Certificate
5 Proof of Experience
6 A separate write up mentioning the details of the post qualification experience.
7 Caste / Disability certificate in case of SC / ST / PWD .
Online Payment Receipt or Bank Challan (Original Depositor’s Copy) with signature of
8 the bank authorities and bank seal (if applicable). Photocopy of the bank challan will not
be accepted.
9 No Objection Certificate (if applicable)
In addition to all the above relevant documents, PhD candidates should also enclose 1)
10 Convocation Certificate 2) Topic Registration Certificate OR PhD Registration Certificate
OR Synopsis Acceptance by the Board of Studies.

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