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-ie-ga.WEST COAST PAPER MILLS LTD..
Omo a wott": P.B. No. 5, Bangur Nagar Dandeli- 581325' U.K. Dist (Kamataka state), lndia
crams: KAGAJI\.4lLL, Phone Nos.: (08284) 231391-395 (5 lines)
Fax Nos.: 08284-230443 0/Vorks Ofiice), 23'1225 (Admn. Office),
E-mail rts.dandeli com

APPLICATION FORM
for emoloyment
Please afiix stamp
size photograph

I Name -----
2. Date of bifih: ---
3. (al Fathels/guardianis name' =_----- - (b) Occupation:
-
4 Locai/ Present address ----------_
:-----
-
5 l\4obile No

5 E-mail lD _-
7. Permanent address

I (a) Religion: ------- (b) N,larital status:

9. Qualiilcation Elective subjecis

1O Month & year of passing Degree / Diploma:

11. Academlc record:

N4onth & Name & place of the Name of the

Examination passed
year of marks institution Board/Universiiy
passinq obtained
SSLC/SSC/1OTH.

PUC / 12TH

..21-
12 Special achievement, if any:

'13. Details of present and previous employment:

Name & place of the Perrod of Post held Nature of work done Salary drawn
Organizatior]
From To

14. Projectwork done in Diploma / Degree / P.G.:

'15. Extra cufticuiar activities

16. (a) N,lothertongue (b) Otiler languages knownl

17. Any additional relevani information

18. References:

1 2

19 Presenl salary drawn'

(please mentjon details the format, enclosed)
1n
-------
20. Salary expected (including perks)

21. When you can join, if selected

Place
Daie: (Signature of the ApPlicant)

Note: Please attach photocopies olmarks cards / certiflcates /testimonials elc-