Under Jurtsaction of Nagpur Court Only é Western Coalfields Limited HUMAN RESOURCE DEVELOPMENT DEPT. (i rtiratne C24 Gor on detain) Wb ste: warw.westerncoa.nicin/e mil 1D: embrd.wel@gmai.com andy) cnc roi0oMHAg7SGO1D26 . ¢ Telefax: 0712-2510869 APPLICATION FOR PRACTICAL TRAINING @ NAME OF THE CANDIDATE —] b GENDER (M/F) ¢ NAME FATHER / HUSBAND DATE OF BIRTH © COURSE PURSUING + SEM/ YEAR F CONTACT NO (MOBILE) g POSTAL ADDRESS FOR COMMUNICATION h e-mail 1D "ANDIDATE'S DETAILS ¢ CONTACT NO OF HEAD OF TRG AT INST 4. DURATION OF SIP/ INDUS. TRG. ¢. DATE OF COMMENCEMENT {PREFERENCE PLACE FOR TRAINING 2 NAME OF THE EMPLOYEE | DESIGNATION ¢ EIS/NEIS 4. PLACE OF POSTING (UNIT & AREA) @. RELATION WITH THE STUDENT hereby cerited that he candidate aplyng for Practica Training at Wester Coalfields Limited i elated with me TONAL INSTITUTE, — UCI FOR Ci'S EMPLOYEES Signature of the Employee - 2 | SEAL & SIGN OF FORWARDING AUTHORITY, SEAL & SIGN OF AREA TRAINING OFFICER DECLARATION | the undersigned declare that Please tick( 7 )in the checkbox against Option) a Tam not related to any employee of WCL /CIL and | agree that I will need to pay a fee atthe rate of Rs 1291/- plus service Tax as applicable per week or as revised time to time, by Demand Draft or A/e payee Cheque in favour WL, ‘Nagpur payable at Nagpur. Lo tam rete ost /smt ____ Designation employee of wel/ cit ‘The informations given by me ae true in best of my knowledge, if found any discrepancy my candidature may be rejected | will abide by the rules and regulations of the company. Signature of the Student Documents to be attached with the Application form : (i). Letter of Educational Institute for Practical Training. (ii) Self attestted Photocopy of Current Identity Card issued by Educational institute.FOR OFFICE USE ONLY 1 2 3 ) < ENROLLMENT NO at WCL HRD: DEPARTMENT / AREA FOR TRAINING NAME OF THE MENTOR Sip TITLE WHETHER RELATED TO EMPLOYEE WCL/CIL ves no O FEE (IF APPLICABLE) Rs. TAX Rs. Torat[Rs. IN WORDS Rupees Incharge of Training WCL HRD Payment Status [Number of /D or Cheque Amount Date of Issue [Name of the Issuing Bank Branch Address of Branch Date of Deposition of the DD/Cheque Reference