केंद्रीय विद् यु त अनुसंधान संस्थान

Central Power Research Institute

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PART - A
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01 Post Name : Engineering Officer
Grade 3
Specialization applied for
02 :
(I/II/III/IV) (Refer advertisement)

03 Advertisement No. : CPRI/11/2024

04 Name in full (in Block letters) :

Category(GEN/EWS/OBC/SC/ST)
05 (Enclose latest certificate as per :
Govt. of India format)

Age and Date of Birth (Enclose

06 a copy of certificate in support of : Date of Birth: ___________________________
age)
Age: Years……………Months………Days……….

07 Gender :

08 Nationality :

09 Father’s/Husband’s name :

10 Address for correspondence

(in Block letters)
:

11 Permanent Address
:
12 Telephone No. (Landline/Cell) : Landline :
& e-mail details.
: Mobile :

: E-mail id :

: Alternate No., if any :

13 Nearest Railway Station from :

where the candidate is likely
to travel for Interview

14 Status of your present :

employment
(Please specify whether Central
Government / Central
Autonomous Organizations /
Statutory Bodies, PSU, Pvt.
Organization, University etc.)
15 Religion :

16 Whether belongs to Persons :

with Benchmark Disability
(PwBD)/ Ex-Servicemen.
(If yes, attach requisite certificate
/documents)
17 Have you applied for any other :
post/employment examination
elsewhere, if so give details.

18 If selected, the minimum time :

required to join the post.

19 Have you executed any bond to

present Employer, if so, please
give details

20 Have you ever been detained in

Police Custody? If yes, please
give complete details thereof.

21 Whether you have been

convicted by any Court of Law?
If yes, please give complete
details thereof.

22 Whether any criminal case is

pending or contemplated
against you in any Court of
Law? If yes, please give
complete details thereto.
 Educational/professional qualification (indicating clearly the examinations
23 passed, University/Board, Year and Month of passing, class and percentage of
marks & specialisation, starting from matriculation) If the examination was
semester wise, marks should be indicated semester wise and copies of marks
sheets of all semesters should be enclosed. If the examination is year-wise marks
should be indicated year wise and copies of marks sheets of all years should be
enclosed, along with certificates, failing which the application will be rejected:
Examin Year and Board/ %age of Marks Class/ Subjects Whether
ation month of University/ semester wise Division taken / marks
passed passing Institution /year wise obtained Specilisat sheets
Semest % of ion enclosed
er/ year marks

(ATTACH SEPARATELY as Annexure – I )

24. Whether continuing higher studies? If so furnish details

Name of Year and Board/University Whether Subjects Year & month

the month of / part time Taken during which
course Regis- Institution or full time the course will
tration or distance be completed
(ATTACH SEPARATELY as Annexure – II )

25 Details of the previous/present employment held, if any, in chronological order

starting from present position backwards (indicating the name of the employer with
full address, post held, salary drawn, period of service, nature of duties etc.).
Supporting documents in the form of discharge letter, experience certificate,
certificate from employer shall be enclosed. Without these documents, the
experience will not be considered.
Name of the Type Post Service Scale of Employme Nature of
Organisation/ (Govt. / held Period pay, nt Type duties
Company with PSU/ From To salary (Permanent performed.
/Contract)
full address Pvt.) drawn (in detail)
(ATTACH SEPARATELY as Annexure – III)

26 Total number of years of work

experience in the relevant field.

27 Area of expertise
28. Details of Journal Papers Published in the Relevant Area/Field (Enclose certificates
or supporting documents as proof).

Sl. Title of the Paper Name of the Type Year of Authorship

No Journal (National/ Publication (First/Second/
International)
Co-author etc.)

(ATTACH SEPARATELY as Annexure – IV )

29. Details of Conference Papers Published in the Relevant Area/Field (Enclose

certificates or supporting documents as proof).

Sl. Title of the Paper Name of the Type Year of Authorship

No Conference (National/ Publication (First/Second/
International)
Co-author etc.)

(ATTACH SEPARATELY as Annexure – V)

30. Details of Research Projects undertaken in the Relevant Area/Field (Enclose

certificates, project report or supporting documents as proof).

Sl. Title of the Project Funding Role in the Brief Outcome

No Research Duration Agency
Project (Principal Description /Results
Project (with Start Investigator/Co- of the
Date - End Investigator/ Project
Date) Researcher, etc.)
(ATTACH SEPARATELY as Annexure – VI)

31. Details of Awards Received (International Awards, National Awards, Best paper
Awards given by recognized International bodies, Govt. of India, or Govt. recognized
bodies) in the Relevant Field (Enclose certificates, letters or supporting documents for proof).

Sl. Name of the Awarding Type of Awarding Date of Whether Reason

No Award Organization Organization (e.g., Award National for
recognized /Internation Award
International al Award
bodies/ Govt. of
India/Govt.
recognized bodies)
(ATTACH SEPARATELY as Annexure – VII)
32. Details of Patents (Enclose certificates or supporting documents for proof).

Sl. Title of Inventor Role in the Patent Patent Holder Patent Brief
No the (s) (e.g., First Inventor, (e.g., Status Description
Patent Co-Inventor, etc.) Individual/ (Granted/ of the
Organisation) Pending) Patent
(ATTACH SEPARATELY as Annexure – VIII)

33. Details of Professional membership (Enclose supporting documents for proof).

Sl. Name of the Membership Type Membership Joining Date Validity of
No Professional (e.g., Member, Number Membership
Organization Fellow, Associate (Annual /Life)
Member, etc.)
(ATTACH SEPARATELY as Annexure – IX)

34 Please specify whether you have 1st Class

BE with 5 years experience or M Tech /
ME with 3 years’ experience or Ph.D.
(Engineering)?

35 Please specify whether you meet the

specialization and experience
requirements in the relevant area for the
post, as specified in the advertisement?

(Clearly specify the specialization and

experience requirements that you fulfill
for the post, along with the relevant
certificates supporting your claim).
 36 Details of any special work carried out /
certification in the relevant field (if any).

37 Name and address of two persons who 1.

have knowledge about your professional
experience.

2.

DECLARATION

I affirm that the information given in this application is true and correct.
I also fully understand that if at any stage it is discovered that any attempt has
been made by me to willfully conceal or misrepresent the facts, my candidature
will be summarily rejected and my employment terminated without notice and
compensation.

Place :

Date : (Signature of the Candidate)

 PART B
[Format for forwarding application through proper channel
(Government organizations/CPSUs/SPSUs/Statutory bodies/Autonomous Bodies)]

Name of the Organization : Reference No. :

It is certified that :

1. The date of birth, qualification, experience and other details given by

Shri/Smt./Dr. _________________________________________as given in
Part A of this application for the post of
_____________________________________at Central Power Research
Institute have been verified and found to be correct.

2. Integrity of Shri/Smt./Dr. ___________________________________________

is beyond doubt.

3. No vigilance or disciplinary proceedings is either pending or

contemplated against the officer.

Signature of the authorized Officer

(Name & Designation)

Seal of the Officer

Full address of the Organisation

Telephone No.