1/3

Recruitment of Engineers

ON-LINE APPLICATION FOR RECRUITMENT OF TEAM LEADER,SYSTEM ANALYST,JR. ENGINEER,DY.EXECUTIVE ENGINEER,STENO TYPIST

14035
Please paste your recent passport size photograph and sign across it. Please retain atleast 5 copies of same photograph with you for subsequent use.

Registration No : Full Name (as it appears on the payment challan): Post : Post Code : Category : Whether availing social reservation benefit ? : Whether possessing Caste certificate issued by the Competent Authority of Govt. of Maharashtra? : Whether possessing Caste Validity certificate issued by the Competent Authority of Govt. of Maharashtra? : Whether possessing Domicile certificate issued by the Competent Authority of Govt. of Maharashtra? :

11561 KUMAR HEMANT Jr. Engineer (Trans) - Trainee 03 Open NO NA NA NA

Whether Possessing recent Non-creamy layer certificate issued by NA the Competent Authority of Govt. of Maharashtra? : Whether availing reservation for persons with disability ? : Type of Disability : Percentage of Disability : Whether taking the help of scribe : Whether availing reservation for WOMEN ? : Whether availing reservation for Sports persons (SP)? : Are you an employee of MSETCL ? : Nationality : Centre of Examination : Centre code : Application Fee / Postal Charges Details : Payment In: Transaction ID / Journal No.: Branch Name : Branch Code No : Deposit Date : Amount : State Bank of India 010978727 ADB KOTA 01838 14-11-2011 550 NO NA NO NO NO INDIAN Nagpur 12

2/3
Personal Details : Date of Birth : Age completed as on 29.11.2011 : Gender : Marital Status : Father's Name / Husband's Name : Mother Tongue : Address for Correspondence : 01-08-1988 23 MALE Unmarried R S YADAV HINDI C/O AJEET YADAV VILL. & POST MANGARI FERTILISER TEHSIL - BIKAPUR District : State : Pin : Permanent Address : FAIZABAD UTTAR PRADESH 224206 C/O AJEET YADAV VILL. & POST MANGARI FERTILISER TEHSIL - BIKAPUR District : State : Pin : Contact Details: Phone No : Mobile No : Email ID : Qualification Details (As on 29.11.2011): Exam Passed SSC : HSC : Graduation : Name of Institute/University CBSE CBSE MPUAT UDAIPUR Subject/Stream SCIENCE PCM Degree in Electrical --Year of Passing 2003 2005 2011 % of Marks 75.00 61.00 74.00 Class / Grade First Class First Class First Class 9461658242 mail.hemantkyadav@gmail.com FAIZABAD UTTAR PRADESH 224206

Do you have minimum speed of 80 w.p.m. in Shorthand and 40 w.p.m. in Typing : Do you Possess Govt. Commercial Certificates? :

Post Qualification work experience details if any as on 29.11.2011 (Start from present Employer) : Name Of Organisation with Annual Turnover Total period of experience (in months) : Total Experience in Power Sector : Total Experience in Transmission Field : Other Details : Languages Known HINDI ENGLISH Read YES YES Write YES YES Speak YES YES Workforce of From(mm/yyyy) To(mm/yyyy) Designation/Post the held Organisation Pay Scale Last Emoluments Nature of p.m Duties/ (excluding Responsibilities perquisites)

3/3
I declare that I have 0 Number of living children as on today, out of which no. of children born after 28.03.2005 is 0. I am aware that if any total numbers of living children are more than two due to the children born after 28.03.2006, I am liable to be disqualified for the post applied.

DECLARATION:
I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found false or incorrect or suppressed or I do not satisfy the eligibility criteria regarding age, qualification & the condition of being domicile of the district my candidature / appointment, at any stage, is liable to be cancelled / terminated

Place: Date: 15-11-2011 Signature of Applicant

KUMAR HEMANT

Please retain your Registration No. and Password emailed to you carefully for further reference NOTE: Please DO NOT SEND application print-out to the Bank