Online Application Form for Coal India Limited

1. Registration Details : 2. Details of Job Applied :

A. Registration No : 0135314 A. Post Code : MT_2011

B. Advertisement Code : CIL_ADVT_MT2011 B. Discipline Applied For : 14 Personnel / HR

3. Personal Details : A. Name : Lakshmi kanth R B. Date of Birth : May 13, 1983 C. Gender : Male D. Maritial Status : Unmarried E. Father's / Husband's Name : Raja P F. Religion : 70 - Hinduism G. Caste : SC H. Physically Challenged / Handicapped : NO Category of Disability : NA 4. Communication / Correspondence Details : A. Address for Communication : 17/1 A EAST ST NO 5 JHONSONPET HASTHAMPATTI; POhasthampatti post office; Town / City-SALEM; State-Tamil Nadu; Pin/Zip : 636007 B. Permanent Address : 17/1 A EAST ST NO 5 JHONSONPET HASTHAMPATTI; PO-; Town / CitySALEM; State-Tamil Nadu; Pin/Zip : 636007 C. Contact Number : 04272417902 D. Primary Email : kanthslm007@gmail.com E. Alternate Email : kanthslm007@sify.com 5. Additional Information : A. Ex-Servicemen Category : No B. Domicile of J & K during 1/1/1980 to 31/12/1989 : No 6. Bank Draft Details : A. Bank Draft No. : NA C. Branch : NA

B. Drawn on : NA D. Date of Issue : NA

7. Other Details : A. Choice of Test Center : 64 - Chennai (TN) 8. Education Details :

Level of Degree / Specializatio Institute qualification Examination n (Major) University / Board C/P Duration of Date / Overall % Course(y&m Tentative ) date of Passing (MM/YYYY) 1Y-0M 3/2000 65.00

Class 10

SSLC

Diploma

Graduate

Bharathi vidyalaya higher secondary school,sale m Diploma in Electronics CSI ECE and Polytechnic communicati college,yerc on engg aud Bachelor of Electronics Sona college engineering and of communicati technology,s on alem

NA

state board

Completed

Statae board Completed of technical education,ta milnadu Anna Completed university chennai

3Y-0M

4/2003

83.00

3Y-0M

11/2008

66.00

Post Graduate

Master of Business Administratio n NA

Human Resource Managemen t NA

NA

K.S.Rangas amy college of technology,T iruchengode NA

Anna university coimbatore NA

Persuing

2Y-0M

7/2011

78.00

NA

NA

NA

NA

9. Declaration : I, Lakshmi kanth R , hereby declare that the information provided above is correct to the best of my knowledge and belief. If any of the information furnished above is found to be incorrect at any stage, my candidature for the post is liable to be cancelled. If at any stage of the selection process, any discripancies are found between the online data filled by me and the application sheet submitted, my application may be summarily rejected. Signature of Candidate ____________________ Date: _________ Place: _________ Enclosures(tick relevant) [ ] Demand Draft (if applicable) [ ] Caste / Disability Certificate by competent authority (for SC/ST/PH/OBC(non-creamy layer) candidates) NOTE: Please paste your recent passport size photo in the space provided and get it attested by a gazetted officer. Departmental candidates can get the photo attested by controlling officer and they should also get the form countersigned and stamped (with official seal) by their controlling officer before sending the same. Applications without signature and date will be summarily rejected. After completing the above procedures, send the application sheet to the address mentioned in the advertisement by post so that it reaches within the last date as indicated in the advertisement. NA stands for not applicable