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4/1/2016 UPPCLAEForm2016

ThanksforsubmittingyourApplicationForm14388whichcanbeusedforallfuture
correspondence
TransactionNo: CP46530572
Amount: 1000.00

ApplicationForm

PersonalDetails

ApplicationNumber: 14388

PostAppliedFor: ASSISTANTENGINEER(T)ELECTRICAL

NameofTheCandidate: SHUBHAMSINGHAL

Father'sName: NATHIRAMSINGHAL

Mother'sName: SHARADLATASINGHAL

UPDomicile: UP

AppliedinCategory: General

Apprenticeunderapprenticeact1961: No

Gender: Male

Nationality: Indian

DateofBirth: 27/08/1993

Age: 22

AgeMonths: 4

AgeDays: 5

CorrespondenceAddress

AddressLine1: Nathiramsinghal

AddressLine2: Nearghaasmadni,Peethbazar

AddressLine3: RampurManiharan

District: SAHARANPUR

State: UttarPradesh

Pincode: 247451

MobileNo: 9259186400

EmailID: singhal.shubham77@gmail.com

AlternateMobileNo: 9780826346

PermanentAddress

PermanentAddress1: Nathiramsinghal

PermanentAddress2: Nearghaasmadni,Peethbazar

PermanentAddress3: RampurManiharan

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4/1/2016 UPPCLAEForm2016

PermanentAddressDistrict: SAHARANPUR

PermanentAddressState: UttarPradesh

PermanentAddressPincode: 247451

QualifyingExaminationDetails

Yearof
Examination Board/School Percentage/Grade
Passing

CBSE/SRDAVPublic
10thorEquivalentExamination 2009 70.83
School

Dateof FullNameof
QualifyingDegree Percentage/Grade
Passing Institution

LovelyProfessional
B.Tech 31/05/2015 68.44
University

TestCenterPreferences

Testcity1: GreaterNoida

Testcity2: Meerut

Testcity3: Ghaziabad

FeeDetail

FeeApplicable: 1000

Declaration

IsolemnlyaffirmthatIhavegonethroughandunderstoodtheeligibilityconditiongivenwiththeAdvertisement2/VSA/2016/AEanddeclareanoaththattheentries
madebymeintheonlineapplicationaretruetothebestofmyknowledge&beliefandifatanystage,ifitfoundtobefalse/incorrect/misinterpretedmycandidature
maybecancelled&disciplinaryactionmaybeinitiatedasdeemedfitbyESC/UPPCL.

Date:2016040122:18:15 CandidateSignature

Version11.00.02

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