BEL : PROBATIONARY ENGINEERS(PE)

- 2010
Application Form

Application No.: 263349

Application for the Post of : PROBATIONARY ENGINEERS(PE) -

*
Electronics

Pe rs o nal Part icul ars

Name (as it appears
Mr. BHURIA PARESHKUMAR
* in your SSLC/SSC
KARSHANBHAI
certificate)
Address for
* 6/64 AKSHAR APPARTMENT
Communication
LAXMIPURA ROAD
LAXMINAGAR

* City/District VADODARA * Pin Code 390023

* State GUJARAT
Contact No. with STD
* 265 -2397488 Mobile No 9824659365
Code
Nearest Railway
* VADODARA * Nationality INDIAN
Station
* Gender MALE
* Date of Birth 28-Nov-1986
* Religion HINDU
pareshkumar28@rediffmail. Alternate E- vinit_rini2000@yahoo.co
* E-mail ID
com mail ID, if any m

Qualif icat io ns De t ails

* Engineering Degree B.E.
* Institution SARDAR PATEL UNIVERSITY
Engineering Degree Month & Year
* Passed * Jul-2009
Status of Passing
Percentage /
Class in
* Branch Electronics * 50.16 /Passed
Engineering
Degree

Emp lo yme nt De t ails

* Are you Employed? NO
If Yes, Type of Name of the
Organisation Organisation
Pay Scale
Designation (CTC for
others)
Ge ne ral Inf o rmat io n
* Category ST
Are you a Domicile of
* J&K During 1.1.1980 NO
to 31.12.1989?
If Yes,Indicate
type of
Are you a Person with
* NO disability and
Disabilities (PWD)? %
Percentage of
disability
Are you an Ex- Service in
* NO 0 Years 0 Months
Serviceman? Defence
If Yes, Indicate
branch of Armed
forces and date of
discharge(DD/MM/YYY
Y)

Writ t e n Tes t De t ail

Language in
which you
* Written test center Mumbai English
want to take
the test

De mand Draf t De t ails

* DD No. 888918 * DD Date 14-Apr-2010
* DD Amount Rs.200
Name of the Issuing MICR No. of
* STATE BANK OF INDIA * 00000 2000
Bank DD
Validity of DD
* DD Payable at New Delhi * 6 MONTHS
is
Declaratio
n
I hereby declare that I have verified the details indicated above and
also confirm that all the information submitted is correct to the best of
my knowledge. At any stage, if it is found that any of the above
information is incorrect and/or is suppressed, the management of BEL
shall have the right to take action, as deemed fit.

Application No. 263349

Place
Date Signature of Applicant
(To be signed prior to despatch)
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Important Instruction for Candidates:

1. Attach your passport size photograph (without attestation) in the space
provided below.
2. Endorse your signatures in the space provided below.
3. Application Form received without two photographs, signatures at two
places and Demand Draft of Rs.200/- will be rejected.

4. Send the duly completed Application form along with requisite amount of
Demand Draft at the following address on or before 23 May 2010 :
Post Box No.3076
Lodhi Road,
New Delhi-110003.
5. Do not send any copy of the certificate alongwith the duly completed
application form. Original certificates of the short listed candidates will be
scrutinized / verified at the time of interview.

Application No.: 263349

Name: BHURIA PARESHKUMAR KARSHANBHAI

Address: 6/64 AKSHAR APPARTMENT
LAXMIPURA ROAD
LAXMINAGAR

VADODARA -390023
GUJARAT
Test Date: 4 July 2010 (Sunday)

Signature of Applicant
(in the space provided)