L & T CONSTRUCTION

P.O.Box: 979, Chennai - 600 089.

Employment Application Form - DET
Position applied for : Diploma Engineer Trainee

Discipline : ELECTRICAL

Reference No : 1201919902

PERSONAL DETAILS
Name in Full INDRESH DWIVEDI

Present Address - Valid Until Permanent Address

MATIYARI CHAURAHA,CHINHAT LUCKNOW, LUCKNOW, UTTAR PRADESH. VILL+POST-BARESTA KALA,PRATAPPUR,P RAYAGRAJ, PRAYAGRAJ, UTTAR PRADESH
Email ID indreshdwivedi54@gmail.com Phone No. 8808231848 Mobile No. 8808231848

Sex Date of Birth Marital Status Nationality Category

Male 01 Feb 1996 UnMarried INDIAN GOC

Passport Number Name as in Passpost Profession as in Passport

Date of Issue Valid Upto Place of Issue Countries valid for

Languages Known Mother Tongue R W S R W S R W S

HINDI ENGLISH

Most Serious Recent Illness No. of Days Ill Nature of Illness

Power of Eye glass Left Eye Physical Disability (if any) Height (cms) 162
Right Eye Weight (kg) 70

EDUCATIONAL DETAILS

Name of the Institute GOEL INSTITUTE OF TECHNOLOGY & MANAGEMENT

Name of the Degree / Diploma with ELECTRICAL Name of Post. Graduation

Specialisation with Specialisation
Scholastic Achievements
Exams Passed Marks Year of Pass Name of the Institute (Distinctions / Awards /
Scholarships)
Scored Maximum

SSC or Equivalent 307 600 201110 UP BOARD

Intermediate or Equivalent 1st Yr.

2nd Yr. 391 500 201305 UP BOARD

Degree or Diploma 1st Yr. 779 1110

2nd Yr. 794 1070

GOEL INSTITUTE OF
3rd Yr. 539 700 201911 TECHNOLOGY &
MANAGEMENT

Average of the Diploma / Degree

marks (in percentage) 75
 AUTOMATIC PHASE COLLECTION
Title of the project work submitted for Diploma

GOOD ENGINEER
What are your future plans regarding higher studies?

FAMILY DETAILS

Name of your family members DOB Relationship Occupation

BRAHMA DEV DWIVEDI 12-02-1972 FATHER FORMER

GULASHAN DEVI 22-10-1980 MOTHER HOUSE WIFE

GENERAL DETAILS
Extra curricular activities͟Please give details about extra -curricular activity with Nature (E.g - Sports, Music, Dance, Drama, positions of responsibility, Social
services, Others), Level (E.g. International, National, State, District, School level, Others ) and Year (Last 10 years)

NO

Relatives / Acquiaintences in L & T group of companies

Name Relationship Position Company

Faculty Reference

SHAILENDRA SHUKLA AMIT AANAND AGRAWAL

Declaration :

I hereby declare that I am not connected with any director of the company as his partner or his relative as detailed as under section 6 of companies act 1956.

I hereby affirm that my answers to the foregoing questions are true and correct and I understand and agree that misrepresentation or omission of facts called for in
this application or other company records shall automatically resigned the contract of employment. I authorize inquiry with regard to my character, ability and habits
to any and all persons and agree to hold such persons harmless with respect to any information that may give.

Signature of Candidate Signature of HR Representative