17 July 2012 Engr Ad Naval Systems App Form

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POSTAPPLIEDFOR:

BHARATELECTRONICSLIMITED
R&FCSNAVALSYSTEMS.

1.Name

AffixyourRecent
Passportsize
photograph

(AsperSSLC/SSCcertificate)

2.Age&DateofBirth

3.Gender :Male/Female

5.Occupation:

6.MothersName

7.Occupation:

8.Nationality

9.Religion :

(ason01.07.2012)

4.FathersName

10.Category

(Enclosecertificateintheprescribedformat)

11.a)IndicateifyouareaPersonwithDisability

ifyes,indicatenatureofDisability

b)DegreeofdisabilityasindicatedintheCertificate

Gen/SC/ST/OBC
VH

HH

OH

12.Minority

:
Muslim/Christian/Sikh/NeoBuddhist/
Zorastrian,Other(pleasespecify)

13.a)Hobbies/SpecialInterests:

b)Whetherparticipatedin :
NCC/Scouts/Cultural
Activities/Debate/
Sportsetc.(PleaseSpecify)

14.Qualification:(Academic/Professional)(indicateclass/division&yearofpassing)

Yearof
Educational
Institution/
MainSubject
Class/
Division
passing
Statusfrom
Percentage
(SSLConwards) University
ofmarks

15.DetailsofExperience(*):

Sl.
Nameofthe
No.
Organization

Startwiththepresentemployment

From
To
Designation Emoluments
Natureof
(CTC)
responsibility
inbrief

(*Encloseseparatesheetifrequired)Pleaseindicatethedate(DD/MM/YYYY)of
joining&exitofeachemployerandalsofurnishthedetailsofbreakinyourservice/
experience(ifany).

16.PostalAddresswithPinCode.

a) PermanentAddress

b)CorrespondenceAddress

MobileNo.:

MobileNo.:

c)emailid:1.

2.

17.PleaseindicateifanyofyourrelativeisemployedinBEL?Ifyes,indicate
Name

Staff

Designation

Department/Unit

18.Undertaking:
Iaffirmthattheinformationgivenaboveustrueandcorrect.Ifurtherdeclarethatifat
any stage it is discovered that an attempt has been made by me to willfully conceal or
misrepresent facts, my candidature may be summarily rejected or my employment
terminated.

SIGNATUREOFTHECANDIDATE
Date :
Place :

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