NEYVELI LIGNITE CORPORATION LIMITED EMPLOYEE DEVELOPMENT CENTRE BLOCK- 20; NEYVELI - 607803 Online Registration - Cum - Application

Form

Photo should be attested by the Principal/Head of the College INPLANT TRAINING - SUMMER - 2012 PREFERRED LOCATIONS PREFERRED DATES : : Neyveli Jul 16 - Jul 23

PERSONAL DETAILS Name of the Candidate Father's Name Sex Date of Birth Community Permanant Address District State Pincode Contact Mobile No Email Address ACADEMIC DETAILS: Name of the Course Period of Study Discipline Name of the College / Institute with Address

: : : : : : : : : :

RAJESHWARI.S SADHASIVAM F 16/07/1992 BC Dharmapuri Tamilnadu 636701 09566642025 rajeshwari200918@gmail.com

District State Pincode OTHER DETAILS: I ) Whether the student is the son/daughter of :

: B.E/B.Tech : 2009-2013 : EEE : J J College of engineering and technology : : Trichy : Tamilnadu : 620009 N

NLC Employee/CISF/INDCOSERVE/CONTRACT WORKMEN/LA (PAPs) If yes Name of the Employee : Designation : Division/Unit in which he/she is working :

CPF No./EPF No./Application

Signature of the UNIT HR/ Head (in case of ward of Regular Employee)

Office Seal II ) Whether the student has already done Inplant Training in NLC If yes Period From : UNIT

: To :

DECLARATION I hereby declare that all the information furnished by me during this online registration are true and correct to the best of my knowledge and belief

Signature of the candidate Registration Date 22-03-12 Registration No 4595 Application with the relevant Documents and certifications should be sent to General Manager/ED, Employee Development Centre, Block-20, Neyveli-607803 so as to reach on or before 21.04.2012 .

NEYVELI LIGNITE CORPORATION LIMITED EMPLOYEE DEVELOPMENT CENTRE BLOCK- 20; NEYVELI - 607803 Online Registration - Cum - Application Form Photo should be attested by the Principal/Head of the College INPLANT TRAINING - SUMMER - 2012 PREFERRED LOCATIONS PREFERRED DATES : : Neyveli Jul 16 - Jul 23

PERSONAL DETAILS Name of the Candidate Father's Name Sex Date of Birth Community Permanant Address District State Pincode Contact Mobile No Email Address ACADEMIC DETAILS: Name of the Course Period of Study Discipline Name of the College / Institute with Address District State Pincode

: : : : : : : : : :

V.SARASWATHI A.VELUSAMY F 19/10/1991 BC Thiruvarur tamilnadu 614102 9095188789 sris.mymail@gmail.com

: B.E/B.Tech : 2009-2013 : EEE : JJ COLLEGE OF ENGINEERING AND TECHNOLOGY : : trichy : tamilnadu : 620009

OTHER DETAILS: I ) Whether the student is the son/daughter of NLC Employee/CISF/INDCOSERVE/CONTRACT WORKMEN/LA (PAPs) If yes Name of the Employee Designation Division/Unit in which he/she is working

: : :

CPF No./EPF No./Application No.

Office Seal

Signature of the UNIT HR/ Head (in case of ward of Regular Employee)

II ) Whether the student has already done Inplant Training in NLC : N If yes Period From : To : UNIT DECLARATION I hereby declare that all the information furnished by me during this online registration are true and correct to the best of my knowledge and belief Signature of the candidate Registration Date 11-04-12 Registration No 7354 Application with the relevant Documents and certifications should be sent to General Manager/ED, Employee Development Centre, Block-20, Neyveli-607803 so as to reach on or before 21.04.2012 .

NEYVELI LIGNITE CORPORATION LIMITED EMPLOYEE DEVELOPMENT CENTRE BLOCK- 20; NEYVELI - 607803 Online Registration - Cum - Application Form

INPLANT TRAINING - SUMMER - 2012 PREFERRED LOCATIONS PREFERRED DATES : : Neyveli Jul 16 - Jul 23 Photo should be attested by the Principal/Head of the College

PERSONAL DETAILS Name of the Candidate Father's Name Sex Date of Birth Community Permanant Address District State Pincode Contact Mobile No Email Address ACADEMIC DETAILS: Name of the Course Period of Study Discipline Name of the College / Institute with Address District State Pincode OTHER DETAILS: I ) Whether the student is the son/daughter of NLC

: : : : : : : : : :

A.SASIKALA P.ARIRENGAN F 02/08/1992 BC virudhunagar tamilnadu 626001 9597810747 sasi.myfriends@gmail.com

: B.E/B.Tech : 2009-2013 : EEE : JJ COLLEGE OF ENGINEERING AND TECHNOLOGY : : trichy : tamilnadu : 620009 : N

Employee/CISF/INDCOSERVE/CONTRACT WORKMEN/LA (PAPs) If yes Name of the Employee Designation Division/Unit in which he/she is working

: : :

CPF No./EPF No./Application No.

Office Seal

Signature of the UNIT HR/ Head (in case of ward of Regular Employee)

II ) Whether the student has already done Inplant Training in NLC If yes Period From : UNIT

: To :

DECLARATION I hereby declare that all the information furnished by me during this online registration are true and correct to the best of my knowledge and belief Signature of the candidate Registration Date 11-04-12 Registration No 7357 Application with the relevant Documents and certifications should be sent to General Manager/ED, Employee Development Centre, Block-20, Neyveli-607803 so as to reach on or before 21.04.2012 .

NEYVELI LIGNITE CORPORATION LIMITED EMPLOYEE DEVELOPMENT CENTRE BLOCK- 20; NEYVELI - 607803 Online Registration - Cum - Application Form

INPLANT TRAINING - SUMMER - 2012 PREFERRED LOCATIONS PREFERRED DATES : : Neyveli Jul 16 - Jul 23 Photo should be attested by the Principal/Head of the College

PERSONAL DETAILS Name of the Candidate Father's Name Sex Date of Birth Community Permanant Address District State Pincode Contact Mobile No Email Address ACADEMIC DETAILS: Name of the Course Period of Study Discipline Name of the College / Institute with Address District State Pincode OTHER DETAILS: I ) Whether the student is the son/daughter of NLC

: : : : : : : : : :

V.RAJALAKSHMI VELLAIYAPILLAI F 06/05/1992 BC madurai tamilnadu 8973748524 rajee.may6@gmail.com

: B.E/B.Tech : 2009-2013 : EEE : JJ COLLEGE OF ENGINEERING AND TECHNOLOGY : : trichy : tamilnadu : 620009 : N

Employee/CISF/INDCOSERVE/CONTRACT WORKMEN/LA (PAPs) If yes Name of the Employee Designation Division/Unit in which he/she is working

: : :

CPF No./EPF No./Application No.

Office Seal

Signature of the UNIT HR/ Head (in case of ward of Regular Employee)

II ) Whether the student has already done Inplant Training in NLC If yes Period From : UNIT

: To :

DECLARATION I hereby declare that all the information furnished by me during this online registration are true and correct to the best of my knowledge and belief

Signature of the candidate Registration Date 11-04-12 Registration No 7360 Application with the relevant Documents and certifications should be sent to General Manager/ED, Employee Development Centre, Block-20, Neyveli-607803 so as to reach on or before 21.04.2012 .

NEYVELI LIGNITE CORPORATION LIMITED EMPLOYEE DEVELOPMENT CENTRE BLOCK- 20; NEYVELI - 607803 Online Registration - Cum - Application Form

INPLANT TRAINING - SUMMER - 2012 PREFERRED LOCATIONS PREFERRED DATES : : Photo should be attested by the Neyveli Principal/Head of Jul 16 - Jul 23 the College

PERSONAL DETAILS Name of the Candidate Father's Name Sex Date of Birth Community Permanant Address District State Pincode Contact Mobile No Email Address ACADEMIC DETAILS: Name of the Course Period of Study Discipline Name of the College / Institute with Address District State Pincode OTHER DETAILS: I ) Whether the student is the son/daughter of NLC Employee/CISF/INDCOSERVE/CONTRACT WORKMEN/LA (PAPs) If yes Name of the Employee Designation

: : : : : : : : : :

T.PAVITHRA TAMILSELVAN F 19/11/1991 BC Ariyalur tamilnadu 8940879372

: B.E/B.Tech : 2009-2013 : EEE : JJ COLLEGE OF ENGINEERING AND TECHNOLOGY : : trichy : tamilnadu : 620009

: CPF No./EPF No./Application No. :

Division/Unit in which he/she is working

Office Seal

Signature of the UNIT HR/ Head (in case of ward of Regular Employee)

II ) Whether the student has already done Inplant Training in NLC If yes Period From : UNIT

: To :

DECLARATION I hereby declare that all the information furnished by me during this online registration are true and correct to the best of my knowledge and belief

Signature of the candidate Registration Date 11-04-12 Registration No 7363 Application with the relevant Documents and certifications should be sent to General Manager/ED, Employee Development Centre, Block-20, Neyveli-607803 so as to reach on or before 21.04.2012 .

NEYVELI LIGNITE CORPORATION LIMITED EMPLOYEE DEVELOPMENT CENTRE BLOCK- 20; NEYVELI - 607803 Online Registration - Cum - Application Form

INPLANT TRAINING - SUMMER - 2012 PREFERRED LOCATIONS PREFERRED DATES : : Neyveli Jul 16 - Jul 23 Photo should be attested by the Principal/Head of the College

PERSONAL DETAILS Name of the Candidate Father's Name Sex Date of Birth Community Permanant Address District State Pincode Contact Mobile No Email Address ACADEMIC DETAILS: Name of the Course Period of Study Discipline Name of the College / Institute with Address District

: : : : : : : : : :

S.POORNIMA SUBRAMANI F 11/04/1992 BC namakkal tamilnadu 8675257300 jothi.mymail@gmail.com

: B.E/B.Tech : 2009-2013 : EEE : JJ COLLEGE OF ENGINEERING AND TECHNOLOGY : : trichy

State : Pincode : OTHER DETAILS: I ) Whether the student is the son/daughter of NLC : Employee/CISF/INDCOSERVE/CONTRACT WORKMEN/LA (PAPs) If yes Name of the Employee : Designation : Division/Unit in which he/she is working :

tamilnadu 620009

CPF No./EPF No./Application No.

Office Seal

Signature of the UNIT HR/ Head (in case of ward of Regular Employee)

II ) Whether the student has already done Inplant Training in NLC If yes Period From : UNIT

: To :

DECLARATION I hereby declare that all the information furnished by me during this online registration are true and correct to the best of my knowledge and belief Signature of the candidate Registration Date 11-04-12 Registration No 7365 Application with the relevant Documents and certifications should be sent to General Manager/ED, Employee Development Centre, Block-20, Neyveli-607803 so as to reach on or before 21.04.2012 .