1/23/2021 ONLINE JOB APPLICATION SYSTEM:PRINT APPLICATION FORM

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APPLICATION FORM
POST:VIDYUT SAHAYAK (JUNIOR ENGINEER-ELECTRICAL)
APPLICATION DETAILS

Application No (Registration ID) 11002342

Application Registration Date/Time 23-01-2021 21:42:23
PERSONAL DETAILS
Applicant Name MR. NEERAJ CHANDRASHEKHAR GUPTA
B 33, SHRI HARI VILLA, NEAR UMA VIDHYALAYA, SOMNATH NAGAR ROAD, TARSALI
Correspondence Address
City VADODARA-390009 State Gujarat
Contact Details Mobile No 8758130334
E-Mail neerajgupta87@ymail.com
Date of Birth 11-07-1991
Gender MALE Category UR
Dependent of Retired Employee of
Marital Status Married No
the Company
Women Candidate-Whether Women Candidate-Whether
N.A N.A
Widow? Remarried?
Is Physically Handicapped? No PH Candidate-Type of Disability N.A
PH Candidate-Percentage of
Ex. Armed Force Personnel No N.A
Disability
EDUCATIONAL QUALIFICATION [GRADUATION DEGREE]
Is ATKT in
Name of Qualifying Division/Grade/
Fulltime/ 7th and/or Result Name of College and Year of Equivalent
Sr. Graduation Marks Grade System %age Obtained
Degree
Regular 8th University Passing
Criteria in Final Year
(%)
Degree? Semester?
BHABHA
B.E. ENGINEERING
1 (ELECTRICAL)
Yes No Pass
COLLEGE BHOPAL
2012 MARKS PERCENTAGE 72.50 72.50
RGTU BHOPAL
EDUCATIONAL QUALIFICATION [SSC AND HSC/DIPLOMA]
Name of School and Year of Division/Grade/%age Equivalent (%)
Sr. Name of Examination Grade System
Exam Board Passing Obtained 00.00 Format
KV ONGC VADODARA
1 SSC 2006 PERCENTAGE 73.50 73.50
CBSE
RC TECHNICAL INSTITUTE
AHMEDABAD
2 DIPLOMA TECHNICAL EXAMINATION
2009 PERCENTAGE 61.88 61.88
BOARD
RECRUITMENT FEES PAYMENT DETAILS
Payment Mode Transaction(PGI) Ref. No. Bank Ref No. Amount Paid (Rs.) Payment Date
ONLINE VSBI9683624592 IGAKIKUFF0 500 23-01-2021
Documents to be produced as and when required by the company
Application Format duly filled in with:
1. Online application form along with two recent passport size photographs should be affixed on the application form.
2. Attested copy of:
i.School Leaving Certificate.
ii.Mark sheets of final year of Graduation/or last two Semesters of Graduation Certificate issued by College/University.
iii.Certificate from the institute/ university mentioning percentage marks obtained in case grading system is in place.
iv.Degree Certificate, if available
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1/23/2021 ONLINE JOB APPLICATION SYSTEM:PRINT APPLICATION FORM
v.Caste (SC/ST/SEBC/EWS) Certificate/Disability Certificate (if applicable).
3. Valid Caste (Roster Category) Certificate of Reserved category of Gujarat State only will be considered.
4. In case of SEBC category candidates, valid non-creamy layer certificate issued in Gujarati – પિરિશ – “ક”/ પિરિશ –
“૪” (ગુજરાતી) by the Competent Authority of Gujarat State.
5. In case of EWS category candidates, valid certificate as per resolution No. EWS/122019/45903/A dtd. 23.01.2019
and dt. 25.01.2019 prescribed format (in English : Annexure – KH” or in Gujarati - પિરિશ – “ગ) in issued by the
Competent Authority of Gujarat State.
6. In case of Physically Handicapped Candidates, Valid Certificate of Civil Surgeon required. (showing % of Disability)
7. In case of Ex. Armed force Personnel, necessary certificate should be attached.
8. In case of Dependent of Retired Employee, Relieving Order or Certificate issued to the employee should be
attached.
9. In case of Widow Applicant, copy of death certificate of the deceased husband should be attached.
10. NOC from present employer (If applicable).
11. Domicile certificate, if applicable.
12. Online fee payment receipt.
13. Identification Proof (Voter ID/ Pan Card/Aadhar Card/Driving License etc).
14. Residential Address Proof (Electricity Bill/Telephone Bill/Ration Card, etc).
Note:- Whenever documents are called from the candidates, submission is to be made by the candidates
within stipulated time, failing which his/her candidature shall be cancelled for the post. Presently, at the time
of application/registration, no documents have been asked.
UNDERTAKING
Undertaking: I certify that the statements made by me in the application are complete and correct to the best of my knowledge
and belief . I further undertake that if any information given herein above is proved wrong then my services are liable to be
terminated from the company, if appointed. I also certify that, no Criminal Proceedings are initiated / pending against me and I
have never been convicted by any Court of Law.I also understand that If I submit the Online Application, but do not forward the
Hard Copy of the application with requisite documents and Fee Challan whenever asked for, then my candidature will be
considered as invalid.
Application Confirmation No 2301110023422157
Application Confirmation
23-01-2021 21:57:26
Date
Date:
(Signature of Applicant) (Signature of Applicant)
Place:
Handwritten Uploaded
This Form Printed on Date/Time:23-01-2021 21:59:28

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