HEAVY ENGINEERING CORPORATION LIMITED, RANCHI 1/5

(A Govt. of India Enterprise)

An ISO 9001:2014 company Paste your
recent passport
Application form for engagement of Apprentices under the NATS (National size colour
photograph
Apprenticeship Training Scheme) for Session 2020-21.

1. Name of the candidate (in BLOCK CAPITAL LETTERS)

Mr. /Ms. __________________________________________
a) Training applied for: - (Graduate / Technician (Diploma) Apprentice) ________________________
b) Year of passing of [(Graduate/Technician (Diploma)] _____________________
c) Discipline applied for: - ______________________________________Group Code: ________

Graduate Group Technician Group

Branch/Discipline Code Code Total
(Diploma)
Civil Engineering 06 101 03 110 09
Computer Science / Information 12 102 06 111 18
Technology
Electrical Engineering 10 103 04 112 14
Electrical and Electronics 06 104 03 113 09
Engineering
Electronics & Communication 06 105 03 114 09
Engineering
Mechanical/Production 55 106 27 115 82
Industrial Engineering 03 107 02 116 05
Metallurgical Engineering 10 108 05 117 15
Secretarial Practice & Accounts
/Office Management & Secretarial 08 109 -- 08
Practice
Total 116 53 169

2. Father’s Name: - _____________________________________

3. Mother’s Name: - ____________________________________

4. Marital Status: - (Married/ Unmarried)

5. Spouse name: - ______________________________________

6. Date of birth (As per 10th pass or equiv. certificate): - ___________________(dd/mm/yyyy)

7. Age as on 30.11.2019: - _______________ (yyyy/mm/dd)

8. Gender: Male / Female / Others: - ______________________________

9. Aadhar No. ________________________________________________

10. Religion: __________________________________________________

11. Nationality: ___________________________________________ 2/5

12. Domicile State: ________________________________________

13. Visible Identification Marks: i) ___________________________

ii) ___________________________

14. Category: - Others/SC/ST/OBC (NCL)/EWS _________________

15. Sub-Caste _______________________

16. Are you a person with Disability [physically challenged] Yes / No: _______

If yes:

a) Type of disability: ___________________________ (VH/HH/OH/MD)

b) Percentage of disability: _______________________

17. Are you a ward of: - HEC Employees / Ex-employees / Contract Worker / Hatia Displaced / Dependent of

Deceased Employees: - Yes/No _________

If yes:

I) If ward of HEC employee, please provide the following:

a) Name of Father / Mother: _____________________

b) Place of Working: _________________________ _

c) Personnel Number: _________________________

II) If ward of HEC Ex- employee, please provide the following: -

a) Name of Father / Mother: _____________________

b) Personnel Number: __________________________

c) Place of Working: ___________________________

d) Date of retirement: _________________ _________

III) If ward of HEC Contract Worker, please provide the following: -

a. Name of Father / Mother: ______________________

b. Place of Working: ____________________________

c. CPF Number: ________________________________

 IV) If ward of Dependent of Deceased Employees, please provide the following: - 3/5

a) Name of Father / Mother: ______________________

b) Personnel Number: ___________________________

c) Place of Working: ____________________________

d) Date of Death of deceased employees: ____________

V) If ward of Hatia Displaced, please provide the following: -

a) Name of displaced person: _____________________

b) Village: ____________________ ________________

c) Khata No.___________________________________

d) Plot No.____________________ _________________

e) Case No. ____________________________________

f) File No. _____________________________________

18. a) Correspondence address: -

19. Name: ________________________House No.______________

Village: ______________________________________________

Post Office: ___________________________________________

Police station; _________________________________________

District: _____________________State: ____________________

Pin code _____________________

b) Permanent address: -

Name: ________________________House No._______________

Village: _______________________

Post Office: ___________________________________________

Police station; _________________________________________

District: _____________________State: ____________________

Pin code ______________________________________________

20. Contact Details: - 4/5
Mobile No. (10 digits only) ______________________________
Alternative Contact No. ________________________________
Email Id: ____________________________________________
Alternative Email Id: ___________________________________
21. Educational Qualification: -
% of marks
Year of Full Marks
Qualification Board/Institute/ University Subject upto 2
passing Marks obtained
decimal

Matriculation

Intermediate

Technician (Diploma)

Graduate (Degree)

Note: Candidates with CGPA pattern have to convert their marks in percentage (%) and attached the
supporting documents for the same.
22. The following documents are to be attached along with the application form as applicable: -
a. Matriculation/10th pass certificate.
b. Mark sheet and passing / provisional certificate of Matriculation or equivalent. (As a Date of birth
certificate).
c. Final Year Mark sheet of Graduate/Technician (Diploma) certificate.
d. Caste certificate [SC/ST/EWS/OBC (Non-creamy layer)] issued by a competent authority. (If
applicable).
e. PWD (Person with disability) certificate (if applicable) issued by civil surgeon/ competent
authority.
f. EWS certificate issued by a competent authority. (If applicable).
g. Certificate of being ward of HEC employee/ Ex. employee/ Contract Worker Hatia displaced/
Dependent of Diseased employee/ Contract worker (If applicable).
h. Aadhar card (UID).
i. Recent 05 (Five) no. passport size coloured photo.
j. Receipt of payment for application fee (HTI copy of challan or Demand Draft).
k. Self undertaking (Enclosed in application form).
Declaration: -
I do hereby declare that all the statement made in this application is true, complete and correct to the best
of my knowledge and belief. I understand that in the event of any information being found untrue or
incorrect at any stage or I am not fulfilling any of the eligibility criteria stipulated, and also in case of
creating influences / undue pressure regarding recruitment shall tantamount to cancellation of my
candidature.

Date:
Place: Signature of Applicant
 5/5

SELF UNDERTAKING

I ________________________________, Son / Daughter of Shri_______________________________

DOB (dd/mm/yyyy) _______________, an applicant for the training of Graduate / Technician (Diploma)

_______________________ discipline ___________________________ do hereby declare the following:

1. I had never been undergone in any training or job experience for a period of one year or more after the
attainment of Graduates or Technician (Diploma).

2. I had never been discharged from apprenticeship training in any of the organization on any reason /
ground.

Signature of the Candidate: ____________________

Name: ____________________________________

Date: ____________________________________