APPLICATION FORM

FOR THE POST OF: ……DH Mechanical…………………………………………………

NAME OF THE APPLICANT: Saroj Kumar Chand……………………………………………

ULTRATECH NATHDWARA CEMENT LIMITED

(Unit:Nathdwara Cement Works)
Teh.: Pindwara, Dist.- Sirohi, Rajasthan-307031
Tel. No.: (02971) 235005 - 012

DIRECT RECRUITMENT SCHEME

ADITYA BIRLA GROUP

(To be filled in by the applicant in his/her own handwriting clearly and completely)
Paste your
Recent
PERSONAL PROFILE
Passport
Photograph
here
NAME : ______Saroj Kumar Chand___________________________________________________________________

ADDRESS FOR COMMUNICATION:

E-mail Address: saroj.chand@adityabirla.com Pin Code: 585292

Phone No. Office: …………………………… Residence: …………………………

PERMANENT ADDRESS:
At Po- Gobardhan Pur
Jajpur road, Jajpur- Odisha-

Phone No. : 9937373800 Pin Code :755019

Date of Birth : 11 / 06 /1977 Place of Birth : Odisha Height : _170_Cms.

Marital Status : Married Blood Group : O +ve Weight___72_____ Kgs.
Date Of Marriage : 31 / 05 /2009 PAN Number : _AFFPC4673M_

LANGUAGE PROFICIENCY: Please indicate proficiency level (Good/Average/Poor)

Language Speak Read Write Language Speak Read Write
English OK OK OK Oriya OK OK OK
Hindi OK OK OK

FAMILY DETAILS: (Including Parents, Dependant Brothers & Sisters)

Sr. Relationship Name Age Highest Occupation
No. Qualification
1 Father
2 Mother Arati Chand 74 House wife

3 Spouse Lipika Raut 36 Graduate House wife

4 Children Sarthak 10 schooling

5 Children Amrit 3 Schooling

6 Sibling
7 Sibling
ACADEMICS / PROFESSIONAL:
Course Period
% Regular/
Examination School / College / (Month &
Specialisation Medium Marks Part
Passed Institution Year) /CGPA Time
From To
10th / SSC Orissa State Board All Oriya 1990 1993 71 Regular
12th / HSC Higher secondary Board PCMB English 1993 1995 51 Regular
Orissa school of mining Engg mechanical English 1999 2001 77 Regular
Diploma Environment &
Diploma in Environment &
pollination English 2005 2005 66 Part time
pollution control ( NILM)
control
Graduation

PG Diploma/
PG Degree
ACADEMICS ACHIEVEMENTS:

a. Prizes / Scholarships / Awards won.

b.
c. What factors contributed to your academic achievements?

EMPLOYMENT DETAILS (Please begin with current job)

Duration Period Nature of

Employer’s Name & Location Designation
From To (Yrs & month) Duties
Maintenance/
ACC Ltd Jr Engg 4.5
2003 2008 Project
Project &
Super cement Engg 1.4
2008 2009 commissioning
UTCL(RCW) 13 maintenance
2009 Till date
/ / / /
/ / / /
Please draw the relevant part of your Organization Chart to specify the reporting
relationship between you, your superior and subordinates (Two level above & Two level
below your position).
FH-Tech

DH-Mechanical

SH Kiln maintenance

FLE Kiln & Preheter FLE Coal Mill FLE AFR Mech Shift maintenance FLE
1 1 1 4
 REFERENCES: (Please give three references of your current organisation who can be
contacted or any person other than your relatives)

Sr. Details of References

References
No. Name Designation Contact No. E-Mail Id
Immediate 887711667
1 HOD
Supervisor Deepak joshi
2 Peers SH 8959590473
Prashun singh
3 Subordinate FLE 8722804808
Sandeep
4 HR Head SH 9538022191
A V R murthy
SPECIALISED TRAINING/ON-THE-JOB TRAINING UNDERGONE:
(Please do not mention routine courses)
Duration
Sr. Certificate
Name of the Training Course Institute/Organisation (days/week Year
No. Awarded
/months)
1 Centered reliable maintenance SKF pune 6 yes 2011
2 Basic hydraulics Kanshbal Rourkels 4 Yes 2012
3

CAREER OBJECTIVES:

a. What made you take up your present subject/area of specialization and what would you
define as your career objective(s)?
As presently looking after maintenance , my carrier objective to be DH mechanical
b. In what way do you think our Group meets your career objectives?
Group enriching my growth time to time

c. What values do you consider important for professional success?

All 5 values

d. Why do you consider yourself suitable for this position?

Already workin as SH since last 8 years & facing number of plant related issue.

MEMBERSHIP OF ANY PROFESSIONAL BODY/ASSOCIATION:

Sr. Type of Membership & Duration of Membership
Name of Institute From To
No. Position Held
1
/ / / /
2
/ / / /
3
/ / / /

LEISURE ACTIVITES:
a. What Leisure time activities do you pursue and how did you develop interest in those?
Visiting pleases & watching TV
b. How do these benefit you?

MISCELLANEOUS:
1. Do you have any physical disability: If yes, give details.
No
2. Have you ever been convicted by a court of Law or is any criminal / civil suit pending
against you in the court?
No
3. Would you be interested in joining our group even Yes No
If no accommodation is provided?

4. Time required to join in case selected: As per Policy

5. Any other information that you may like to provide:

(A) ADDITONAL INFORMATION

How did you come to know about this vacant position?

Advertisement Campus Poornata

Others
Reference Consultant
(Specify)
Have you ever applied or been interviewed by any Units of Aditya Birla Group Company? (Yes/No)

Sr. No. Unit Name Position/ JB Department Year/Month

1 Dhule JB8 Mech Oct 22
2
Have you ever been employed by any Units of Aditya Birla Group Company? (Yes/No)
Relieving
Sr. No. Unit Name Position/ JB Department Joining date
date
1
Do you have any relative working with any Units of Aditya Birla Group Company? (Yes/No)

Sr. No. Name Relationship Unit Name Position/ JB Department

Previous Organization Benefit Account Details (Numbers)

PF Super Annuation ESI

(B) FOR IRS (INTERNAL CANDIDATES ONLY)

Current Job Band : SH Mechanical Effective from 01.01.2014
Current Designation: ____AGM Effective from ___2021
Are you fully aware about IRS policy (784 & Global Mobility Policy)
Have you ever reported to manager you are about to report after joining this Unit? (Yes/ No)
Have you received an offer from any Aditya Birla Group Company prior to this interview during
last 3-4 years? (Yes/ No)

REMUNERATION DETAILS WITH PRESENT EMPLOYER, IF ANY

PER MONTH PER ANNUM

DETAILS OF EMOLUMENTS (RS.) (RS.)
- Salary (Basic + DA)
- Conveyance Allowance
- Education Allowance
- LTA
- Medical Allowance
- Special Allowance
- Uniform Allowance
- Any other Allowances : (1)
: (2)
Sub Total ( A ) , , . , , .
- PF Contribution
- Gratuity
- Superannuation
- Bonus / Exgratia
- Any Perf. Linked Incentive
Sub Total ( B ) , , . , , .
- HRA / Accommodation
- Any other City Allowances
Sub Total ( C ) , , . , , .
GRAND TOTAL , , . , , .

Present:
Salary + Monetary Non-Monetary Benefits/
Perquisites (Rs.) Per annum Perquisites

Expected :
Salary + Monetary Non-Monetary Benefits/
Perquisites (Rs.) Per annum Perquisites

The information given by me is true to the best of my knowledge.

Note: - Details declared above shall have to be satisfied with proof on joining.
 Saroj kumar chand
(SIGNATURE)

RELATIONSHIP DECLARATION

ATE: 18.11.2022

I ______________________________________________________ hereby solemnly declare that:

(1) Mr. ________________________________________________ who is working as

___________________________ in________________________ Department is related to me as

_________________________ (relationship).

(2) None of the employee (s) of this plant or any other Aditya Birla Group
Companies is related to me.

Declaration
The above information is true to the best of my knowledge and if it is found as false, I shall
be liable for severe disciplinary action by the Company.

Name : Signature:……………………

Date :

Acknowledgement by Candidate
(To be filled on issuing Offer Letter/Letter of Intent)

Offered Job Band: ________

FC w/o Housing: Rs.______________/- per annum

Designation: ____________________

Accommodation: (Family Accommodation/ Bachelor/HRA)

I hereby declare that I have completely understood the CTC structure & accept the above
mentioned compensation details.

Name:Saroj chand Signature

Date:18.11.2022 Saroj kumar chand