Online Application Form for Coal India Limited

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

A. Registration No : 0011998 A. Post Code : MT_2011

B. Advertisement Code : CIL_ADVT_MT2011 B. Discipline Applied For : 02 Mechanical

3. Personal Details : A. Name : sandeep singh B. Date of Birth : Jan 15, 1990 C. Gender : Male D. Maritial Status : Unmarried E. Father's / Husband's Name : Dr. Ravindra Pratap Singh F. Religion : 70 - Hinduism G. Caste : GEN H. Physically Challenged / Handicapped : NO Category of Disability : NA 4. Communication / Correspondence Details : A. Address for Communication : kendriya vidyalaya railparisar; PO-badgaon; Town / City-gonda; StateUttar Pradesh; Pin/Zip : 271002 B. Permanent Address : kendriya vidyalaya railparisar; PO-badgaon; Town / City-gonda; State-Uttar Pradesh; Pin/Zip : 271002 C. Contact Number : 09450328667 D. Primary Email : sandeepsngh59@gmail.com E. Alternate Email : smartsandeepsingh@yahoo.co.in 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. : 693480 C. Branch : runkuta

B. Drawn on : State Bank of India D. Date of Issue : Jun 01, 2011

7. Other Details : A. Choice of Test Center : 59 - Delhi (DL) 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 4/2004 77.68 1Y-0M 4/2006 72.60

Class 10 12th

yes yes

NA physics,che mistry,maths , biology,engli sh MECHANIC AL ENGINEERI NG NA

Graduate

B.Tech.

NA

NA

K.V. BEG& CENTER ROORKEE KENDRIYA VIDYALAYA No.1, JHANSI CANTT. ANAND ENGINEERI NG COLLEGE,A GRA NA

CBSE CBSE

Completed Completed

GBTU

Persuing

4Y-0M

7/2011

69.28

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

9. Declaration : I, sandeep singh, 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