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Venue: Date of Selection: Application Form: Neyveli Lignite Corporation Limited

It also asks if the applicant is related to any NLC employees, if they have ever been convicted or have legal cases pending against them, and includes checkboxes for documents to be enclosed like community certificate, birth proof and marksheets.

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Raja Durai
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© Attribution Non-Commercial (BY-NC)
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77 views3 pages

Venue: Date of Selection: Application Form: Neyveli Lignite Corporation Limited

It also asks if the applicant is related to any NLC employees, if they have ever been convicted or have legal cases pending against them, and includes checkboxes for documents to be enclosed like community certificate, birth proof and marksheets.

Uploaded by

Raja Durai
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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NEYVELI LIGNITE CORPORATION LIMITED

(A “MINI RATNA” Govt. of India Enterprise)


P.O. NEYVELI-607 801, Cuddalore District, Tamil Nadu
(Regd. Office: 135 Periyar EVR High Road, Kilpauk, Chennai-600 010) Affix recently
taken
CAMPUS SELECTION color
FOR RECRUITMENT OF GRADUATE EXECUTIVE TRAINEES passpo
rt size
VENUE : photogr
aph
DATE OF SELECTION :
APPLICATION FORM
(Use Block Letters)
1. Name in full :

2. Father’s Name:

3. Mailing Address of the applicant

Description (a) Permanent (b) Present

House No./Room
No./Plot No.
Street Name
Area / Locality / Nagar
Village / Town / City
Taluk / Mandal

District

State

Pincode

Mobile No:

(c) email : ………………………………………………………………………

4. Date of Birth (Enclose documentary evidence) :

D D M M Y Y Y Y

Age as on 01-02-2011 : _____Years _____ Months _____ Days

5. Gender Male Female

6. (a) Community : SC ST OBC UR

(b) Sub-Caste :

(c) Religion :

(d) Nationality :

By Birth / Domicile

(e) Place of birth :

State :

(f) Hometown :
(g) Whether belong to Persons With
Disabilities category ? NO VH HH OH

7. Details of Professional course pursuing presently:-

Whether cleared
Whether % of marks
all the papers
Discipline/ presently pursing secured upto
Name of the Degree upto Previous
Specialization Final Semester previous
Semester.
(Yes / No) Sememter
(Yes / No)

8. Languages known (Please put  mark)

Languages Speak Read Write

(a) Mother Tongue ………………………..

(b) Other Languages:

. i)

. ii)

. iii)

. iv)
9. Are you related to any employee of NLC ? :
(Father, Mother, Sister, Brother or any relative) YES NO

If Yes, details of the related employee Name


:
Relationship
CPF No.
Status Serving Retired Expired

10. a) Have you ever been convicted / detained /


prosecuted / arrested / bound down / debarred/ YES NO
fined by Court of law? If so furnish details.
b) Is any case pending against you? If yes,
give details.

I hereby declare that all the above informations furnished by me are true and complete. I am aware
that furnishing of false / incomplete informations will result in loss of employment at any stage.
I also undertake to notify any changes in the information furnished, within 7 days of such change.

Place:
Date:
Signature of the applicant
List of Enclosures
(Indicate the copies of documents enclosed by putting tick() in the appropriate box)
Copy of Community Certificate (in case of SC/ST/OBC candidates)
Evidence for Date of Birth
Copies of Mark sheets upto the previous Semester

(To be certified by the concerned Training & Placement Officer of the Institution)
Certified that the particulars given under column 7 has been verified and found to be correct.
Date: Signature of Training & Placement Officer

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