English Application Form 23 11 09

APPLICATION FORMAT FOR THE POST OF ARTISAN IV
INITIALLY AS TEMPORARY EMPLOYEE (ARTISAN)
1. Trade : ____________________________ Affix passport

size photograph
2. Name of the applicant : ____________________________ duly signed by
(in capital letters) the candidate
3. Date of Birth :
Day Month Year
st
Age as on 1 Nov 2009 : Years Months
4. Gender- Please (√ ) : Male Female
5. i) Father’s name : _______________________________

ii) Father’s occupation : _______________________________
iii) In case of BHEL Employee : Staff number _________ BHEL Unit:_______

wards state staff no. and current
status of employment of parent Status:Serving Retired Resigned
such as Serving/Retired/Resigned/
Deceased/Removed/Dismissed Deceased Removed Dismissed
6. i) Caste/Category –Please tick (√ ) : General OBC (Non Creamy Layer)

Caste/Community Certificate should SC ST
be attached
ii) Religion : ________________
iii) Whether Physically Challenged Yes No

Please tick (√ )
If yes, type & percentage of Disability : _________________
Locomotor Locomotor disability in Percentage ----------%
Hearing impaired Hearing impaired disability in Decibels: ________
Visually Impared Disability in Percentage ----------%
iv) Whether Ex Serviceman Yes No
if yes, No. of years of Service _________ years
7. Whether seeking age relaxation as Yes No

J&K candidate (Please enclose Certificate)
8. Postal address
_____________________________________________
_____________________________________________
______________________________________________
______________________________________________
_________________________Pin__________________
Contd…
::2::
9. Academic & Technical Qualification:
Examination Dura- Year of Subject/ Name of Board/ Marks Max. % of
Passed tion of passing Trade University/ITI obtained marks marks
course
X Std (10th )
Plus Two/ Int

ermediate(12)
ITI- NTC
10. Whether undergone Apprenticeship Training under Apprentices Act 1961: Yes
Please tick (√ ) No
It Yes, furnish details of apprenticeship training
Name of Period of training Trade Stipend National Apprenticeship Certificate % of
organization per Marks marks
From To month Marks obtained Maximum marks
11. Experience:
Experience, if any
Name of Experience Nature of Job Emoluments

organization & Post Held (Rs per month)
Address From To
12. Whether BHEL departmental candidate Yes No

13. Bank Demand Draft : No. Dated Amount Rs.
14. Telephone No.s/E-mail address, if any __________________
15. Mother Tongue: __________________
16. Languages Known 1. Write_________ Read_________ Speak ________
2. Write_________ Read_________ Speak ________
3. Write_________ Read_________ Speak ________
17. Computer Knowledge : ______________________________________
Declaration
I herby declare that all statements as mentioned in this application are true, complete and
correct to the best of my knowledge and belief. I understand that in the event of any particulars
or information given above being found false or incorrect, or if at any stage it is found I do not
possess the prescribed qualification for the post, my candidature will be rejected ab initio and
I will not have any right/claim to the post.
Encl: 1 2 3
4 5 6
Date: (Signature of Candidate)
To,
Dy General Manager (HR)
Human Resource Deptt., ADM Bldg.
Bharat Heavy Electricals Limited, JHANSI (UP)-284129
UNDERTAKING (for OBC Candidates)
“ I ________________________ son/daughter of Sri___________________ resident of

village/town/city ____________District ____________, State _________ hereby declare
that I belong to the ___________ caste / community which is recognized as a backward
class by the Government of India for the purpose of reservation in services as per orders
contained in Department of Personnel and Training Office Memorandum No. 36033/3/2004-
Estt. (Res) dated 14.10.2008. It is also declared that I do not belong to persons/ sections
(Creamy Layer) mentioned in the schedule to the above referred office memorandum dated
14.10.2008.
Name: ------------------------------------ (Signature of candidate) ----------------------
Roll No: ------------------------------------- Date: -----------------------

English Application Form 23 11 09

Uploaded by

Copyright:

Available Formats

English Application Form 23 11 09

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

English Application Form 23 11 09

Uploaded by

Copyright:

Available Formats

APPLICATION FORMAT FOR THE POST OF ARTISAN IV

INITIALLY AS TEMPORARY EMPLOYEE (ARTISAN)

1. Trade : ____________________________ Affix passport

4. Gender- Please (√ ) : Male Female

5. i) Father’s name : _______________________________

iii) In case of BHEL Employee : Staff number ___ BHEL Unit:_

6. i) Caste/Category –Please tick (√ ) : General OBC (Non Creamy Layer)

ii) Religion : ________________

iii) Whether Physically Challenged Yes No

iv) Whether Ex Serviceman Yes No

if yes, No. of years of Service _________ years

7. Whether seeking age relaxation as Yes No

Plus Two/ Int

Name of Experience Nature of Job Emoluments

12. Whether BHEL departmental candidate Yes No

“ I ______ son/daughter of Sri_ resident of

Name: ------------------------------------ (Signature of candidate) ----------------------

Roll No: ------------------------------------- Date: -----------------------

You might also like