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Application form DIPLOMA

This document is an application form for the position of Diploma Engineer (Trainee) at MECON Limited, a Government of India enterprise. It requires personal information, academic qualifications, and additional training details from the applicant, along with a declaration of the truthfulness of the information provided. The form also includes sections for office use to verify the applicant's details.

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bhardwajdhruv.127
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16 views

Application form DIPLOMA

This document is an application form for the position of Diploma Engineer (Trainee) at MECON Limited, a Government of India enterprise. It requires personal information, academic qualifications, and additional training details from the applicant, along with a declaration of the truthfulness of the information provided. The form also includes sections for office use to verify the applicant's details.

Uploaded by

bhardwajdhruv.127
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 2

MECON LIMITED

(A GOVERNMENT OF INDIA ENTERPRISE)


RANCHI – 834002, JHARKHAND

APPLICATION FORM Affix recent colored


passport size self
attested photograph

BoPT Enrollment ID: ____________________________________

1 POST APPLIED FOR DIPLOMA ENGINEER (TRAINEE)

NAME (IN CAPITAL)


2
(As appearing in matriculation certificate)

3 FATHER’S/ SPOUSE’S NAME

GENDER Marital Status Married / Unmarried / Others


4 Male Female Others
(Put a tick mark) (Please specify if Others)
(Put a tick mark)

D D M M Y Y Y Y NATIONALITY
5 DATE OF BIRTH

Age
(As on prescribed Month
6 Year Days
date in s
advertisement)

CATEGORY OBC (Non


Gener
7 SC ST Creamy EWSs (Attach documentary evidence)
(Put a tick mark) al
Layer)

Whether Person If Yes, State the nature of Disability


8 with Disability Yes No (OH/VH/HH/Others) …………... (Attach documentary evidence)
(Put a tick mark) % of disability………………..

9 ACADEMIC AND PROFESSIONAL QUALIFICATIONS (Starting from Matriculation)

Name of Whether full Duration Name of the Month &


Main Subjects/ Grade# / %
Examination time / part time/ of the Institution / year of
Specialization marks
passed correspondence course University passing *

* Date of declaration of result/ date of issue of final semester marks sheet/ provisional certificate/ degree,
whichever is earlier will be considered as the date of passing the examination.
#Equivalent % to be mentioned in bracket.
(Please attach self attested copies of all certificates/ mark sheets)

Page 1 of 2
10 Details of additional qualification(s)/training(s) undergone (if any)

Name of Duration of Month &


Whether full Name of the Main Subjects /
qualification/ the course/ year of Grade / % marks
time/ part time/ Institution/ Specialization /
Training Training passing/
correspondence University Training content
Programme programme Training

(Please attach self attested copies of all certificates/ Testimonials)

11 ADDRESS (Please give full postal address with postal pin no.)

PRESENT ADDRESS OF THE CANDIDATE PERMANENT ADDRESS OF THE CANDIDATE

MOBILE NO. OF CANDIDATE E-MAIL OF CANDIDATE

I hereby certify that the information provided above is true to the best of my knowledge and in case any
information as above is found to be false or in-correct or suppressed at any stage, I understand that I am liable
to be terminated from the services of MECON Limited forthwith without prejudice to any other legal and
disciplinary action as deemed fit by the Management.

Place: ……………….

Date: ……………….. (Signature of the


Applicant)

For Office Use Only


Date of Educational
Work Experience Category (SC/ST/OBC/EWS/PwD)
Birth Certificate(s) Remarks
verified Certificate verified, if any
verified checked

(Signature of Verifying

Name : Designation: Officer)

Page 2 of 2

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