Affix recent passport

Size colour
(GHAZIABAD UNIT) photograph signed by
the candidate. Do
not use stapler or
pin.
NAME OF THE POST : _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ _

1. Name of the candidate in full

(As per SSLC/SSC Certificate): __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ _

2. Father’s Name : _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __

3. Age / Date of birth : _ _ __ _ __ _ __ _ __ _ ___ _4. Gender : MALE/FEMALE

5. Nationality: _ _ __ _ __ _ __ _ __ _ __ _ 6. Religion (Please specify) : _ _ __ _ __ _ __ _ __

7. Category : _ _ __ _ __ _ __ _ __ _ __ _ _(GENERAL/OBC/SC/ST/PWD)

8. E-Mail: _ _ __ _ __ _ __ _ __ _ __ _ _

9. Mobile No. _ _ __ _ __ _ __ _ __ _ __ _ _

10. Address:
PERMANENT CORRESPONDENCE

Phone No.(With STD Code): Phone No.:

11. QUALIFICATION (From SSLC/SSC Onwards):

Qualification Institute / University % of * Year of Subject/
Marks/ passing Discipline
CGPA
10th Standard

12th Standard
Graduation/
B.E/B.Tech

Post Graduate/
M.E/M.Tech

Other Higher
Education/
Professional
Qualification
*Aggregate %age of all Semesters
12. EXPERIENCE (Start with the Existing employer) (If required please attach separate
sheet):

Name of the Employment Details Designation Cost to Area of work

organization the
From To Company

13. Please give particulars of your relative employed in BEL, if any:

Name Relationship Designation Department Unit

14. Have you appeared for any previous selection for Appointment in BEL? If so, please
furnish details in brief:

15. SBI Reference No.: _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _

UNDERTAKING

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

SIGNATURE OF THE CANDIDATE

Date:
Place: