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A 'Mini Ratna' &Schedule 'A' PSU CAREER OPPORTUNITIES IN A GROWING ORGANISATION REGISTATION SLIP Application Personal Details: Application No SJVN301624 Name of the Candidate NISHANT PANDEY Gender Male Father's Name VIJAY SHANKAR PANDEY Domicile State Uttar Pradesh Category General Whether belong to Minority Community No J &K Candidates No Date of Birth 25-09-1991 Post Applied for ET-Electrical Educational Qualification B.Tech Electrical-74.10% Test Centre Choice Delhi , Dehradun Applicant's Photograph &Signature &Certificate Applicant's Photo Applicant's Signature Applicant's Communication Details: Permanent Address: OLD H-11, KABIR COLONY, B.H.U., VARANASI, 221005, Uttar Pradesh Communication Address: OLD H-11, KABIR COLONY, B.H.U., VARANASI, 221005, Uttar Pradesh Contact Mobile Number 8866503556 Telephone NumberNo(If any) : 0542 - 2369332 Email ID : nishant4889@gmail.com Declaration I hereby declare that I have carefully read the condition of eligibility mentioned in the advertisement. These conditions are acceptable to me and I fulfill these conditions. The details mentioned in the application are true and I shall furnish the necessary certificates in proof of the above along with the application. If any information/details found to be incorrect/false at any stage of selection or if any fact is found to have been concealed by me are detected even after the appointment, my service may be terminated. _________________________________ ( Applicant's Signature )