Bajaj Auto Limited PHOTOGRAPH

Akurdi, Pune – 411 035.

Position applied for : GRADUATE / DIPLOMA TRAINEE ENGINEER

SANDWICH / INPLANT TRAINEE

Discipline / Branch: (MECHANICAL/ AUTOMOBILE/ ELECTRICAL/ ELECTRONIC ____________________________ ENGG.)

(NB : This application form MUST be completed in all respects in the candidate’s own handwriting.)

1. PERSONAL DETAILS :

NAME IF FULL : ______________________________________________________________________________________

(CAPITAL LETTERS) (FIRST NAME) (MIDDLE NAME) (SURNAME)
Present Address : Permanent Address :

Pin : Pin :
Tel No : Tel No :
Mob No : Mob No :
Email Address :
Date of Birth : Age : Marital Status :
Place of Birth : Domicile State : Religion :
Height in cms. : Weight in Kgs : Blood Group :
Power of glasses , if any Left Right: Physical deformity, if any
Category (Open/ SC/ ST/ any other)
Mother tongue
English Hindi Marathi Foreign Language
Read
Write
Speak
Family background :
Relation Name Age Occupation
Father
Mother
Brother
Sister
Details of extra curricular activities ( e.g. Sports, Games, Hobbies, etc.)
2. EDUCATIONAL BACKGROUND: SANDWICH / REGULAR / ANY OTHER
(Complete the following columns in all respects and mention failures / ATKT (if any) against each exam.)
Sr. No Exam School / College Board / University Year % of Result : Pass/ Fail /
marks ATKT
1
SSC

2
HSC / ITI

I Sem
3 I Yr.
II Sem
I Sem
4 II Yr.
II Sem
I Sem
5 III Yr.
II Sem
I Sem
6 IV Yr.
II Sem
I Sem
7 V Yr.
II Sem
8 Additional
Qualification, if any
Project assignment / Seminar / mini projects, if any completed as Scholarships, Prizes, Awards etc., if any :
a part of the course, if any :

Details of Internship / In plant Training / Employment (If any) :

Name of the Company Duration Details of training / employment

3. Do you have any relatives working in Bajaj Auto? If yes, please give details
Name Relationship Department Location

4. Give name & addresses of two references other than relatives

1. _________________________________________ 2. _______________________________________________
_________________________________________ _______________________________________________

I hereby certify that the above statements are true and correct. I understand and fully agree that any statement made
herein found to be erroneous and any omission which tends to mislead the company will be sufficient cause to remove
me from the service of the company at any time during my training / employment.

Date: - ____________ ____________________

Place: - ____________ (Signature of Applicant)