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Indian Oil Corporation Limited

(A Government Of India Undertaking)

Application form (Personal & Confidential)

Please take the print out of the application form in A4 size portrait format only
GATE Reg. No. #
Indianoil Reg. No.#
Date

: EC-55022S1267
: 877060
: 10-01-2015

Post Applied
Candidate's Name

: Officer/ Engineer
: Mr.DEVESH KUMAR MISHRA

Father's / Husband's Name

Relationship
Date of Birth
Gender
Choice for Interview Centre
Contact No

: MANOJ MISHRA
: Father
:02-12-1990
: Male
: Delhi
: 8305333341

Email Id
Alternate Email Id
Are You presently in Employment with IOCL
Category
State of Origin / Domicile
Religion
Whether belong persons with Disabilities(PWD)?
Whether Ex-Serviceman
Domiciled in JK (between 01.01.1980 and
31.12.1989)
Marital Status
Discipline Applied For
Discipline Code

: deveshmishra1967@gmail.com
:
: No
: Gen
: MADHYA PRADESH
: Hindu
: No
: No

Paste your recent self

attested Passport size
photograph and it should
be the same as
submitted along with
GATE Application form

: No
: Unmarried
: Electronics & Communication Engineering
: EC

Educational Qualification Details

Name of Degree
Branch / Name of the Course
Month & Year of Passing
Course Duration
Whether Full time Regular Course
whether Completed
% of Marks
College / Institution Name
Name of Affiliate University
Course Approved by AICTE

: B.E.
: Electronics & Communication Engineering
: 05-2013
: 4 Y - 0M
: Yes
: Yes
: 65.83
: INSTITUTE OF ENGINEERING AND TECHNOLOGY
: DEVI AHILYA VISHWAVIDYALYA
: Yes

Address for Correspondence

Address1
: JUNIOR HIG 19 B SECTOR RAJEEV
Address2
: NAGAR AYODHYA BY PASS ROAD
City / Town
: BHOPAL
State
: MADHYA PRADESH
Pincode
: 462041
Nearest Railway station

Permanent Address if different from above

Address1
: JUNIOR HIG 19 B SECTOR RAJEEV
Address1
: NAGAR AYODHYA BY PASS ROAD
City / Town
: BHOPAL
State
: MADHYA PRADESH
Pincode
: 462041

: HABIBGANJ

All the information given in this application form are true to the best of my knowledge and belief. If any of the information is found incorrect, my candidature may be cancelled.
Date:
Signature:
CANDIDATE TO PLEASE NOTE:
1. Please note your IOCL registration no. for future reference
2. Please visit our website after about 3 weeks of declaration of GATE 2015 result for further information.
3. Please retain the photograph uploaded for GATE 2015 application. If you are shortlisted for further selection process. Same photograph may be required to be uploaded.
4. Mobile no. and email ID mention in this application form should remain valid for at least next one year.
5. If you are shortlisted for interview you will be required to produce this application form.
6. You may contact our helpline number 1860 354 0112 or write to us at recruit2015@indianoil.in