ASHWANI

1

EMPLOYMENT APPLICATION FORM

POST APPLIED FOR: Sr. ENGINEER/ASSISTANT MANAGER

PER

SON

AL

DAT

A

FULL NAME IN BLOCK LETTERS

ASHWINI

(LAST) (FIRST) (MIDDLE)

PRESENT HOME MAILING ADDRESS: VPO UGALAN HISSAR THESIL HANSI

HNO 171 DIST HISSAR

TEHSIL HANSI PIN CODE 125038

TELEPHONE (With Code) CELL: 9468260464

E-MAIL : BIRTH DATE

PERMANENT HOME MAILING ADDRESS: C/O SHRI BHAGWAN 4/12/1993

VPO UGALAN HISSAR THESIL HANSI 22

VPO UGALAN HISSAR THESIL HANSI PIN CODE 125038 BIRTH PLACE

TELEPHONE (With Code) CELL: 9468260464 UGALAN

GENDER MARITAL STATUS NATIVE STATE RELIGION NATIONALITY STATE OF DOMICILE

MALE SINGLE HARYANA HINDU INDIAN HARYANA

CASTE [Other than GEN.CAT please arrange to produce Caste Certificate]

LANGUAGES KNOWN (Including Foreign) SPEAK READ WRITE PASSPORT NO.

ENGLISH PASSPORT ISSUE DATE

HINDI VALID UPTO DATE

ODIA COUNTRY OF ISSUE

AADHAR NO. 235834047799

PAN NUMBER

BANK A/C DETAILS 20282462838(SBI)

DETAILS OF FAMILY MEMBERS (parents, spouse, children, siblings & any other dependents excluding self)

NAME RELATIONSHIP DATE OF BIRTH QUALIFICATION OCCUPATION ORGANIZATION AND POSITION

USHA RANI MOTHER 10/9/1977 12TH HOUSE-WIFE

SHRIBHAGWAN FATHER 22/10/1974 MA TEACHER

AMIT BROTHER 2/10/1995

EMERGENCY CONTACT DETAILS NAME SHRIBHAGWAN

ADDRESS VPO UGALAN HISSAR THESIL HANSI

RELATION FATHER TELEPHONE NO. 9416142162

HEA

LTH

DAT

A HEIGHT (cms) WEIGHT (kg) BLOOD GROUP PHYSICAL DISABILITY (IF ANY)

182 75 0+ Right LeftNO

IDENTIFICATION MARKS

CUT MARK ABOVE RIGHT EYE

EDUCATION

EXAMINATION PASSED

PLEASE AFFIXYOUR RECENTPASSPORT SIZEPHOTOGRAPH

ashwini [email protected]

AGE (YRS)

MARRIAGE DATE(If Married)

POST GRADUATE STUDENT

EYESIGHT [SPECIFY POWER IF WEARING GLASSES/LENSES]

SPECIALISATION

SCHOOL / COLLEGE / INSTITUTION

UNIVERSITY/ BOARD

WHETHER FULLTIME / PARTTIME/ CORRES.

DURATION OF COURSE

(Yrs & Mths)

MONTH & YEAR OF PASSING

GRADE % MARKS

DISTINCTIONS / SCHOLARSHIPS / PRIZES

WON

SC ST DT NT SBC OBC GEN.CAT

mailto:[email protected]

2

HBSE FULL TIME 1YR 2009 65

DIPLOMA POLYTECH EE HSBTE FULL TIME 3YR 2012 60

DEG

REE

(S)

1 EE KUK FULL TIME 4YRS 2015 71.2 B.TECH

MEMBERSHIP OF PROFESSIONAL INSTITUTE

NAME OF INSTITUTE TYPE OF MEMBERSHIP AND POSITION HELDDURATION OF MEMBERSHIP

PERIOD FROM TO

TRAINING / CERTIFICATIONS

NAME OF THE TRAINING COURSE DURATION YEAR INSTITUTE / ORGANISATION

132 KV SUB STATION 6 WEEKS 2015 JIND SUBSTATION YES

220 KV SUBSTATION 4 WEEKS 2012 KARNAL SUBSTATION YES

PAPERS PUBLISHED / PRESENTED

TITLE NAME & DATE OF THE SEMINAR / JOURNAL IN WHICH PRESENTED / PUBLISHED

EXTRA CURRICULAR ACTIVITY (E.G. Sports, Social & Literary activities etc.)

ACTIVITY INSTITUTION/ASSOCIATION/SOCIETY/CLUB YEAR POSITION HELD PRIZES WON

SKILLS SUMMARY (Give brief details for the projects you have worked on)

PROJECT TITLE ROLE TEAM SIZE DURATION LANGUAGE / PLATFORM / OS

ELECTRICAL BOAT AS A BASIC MODEL OF BOAT IN LARGE SEA 4 2013- 2014 ELECTRICAL BOAT

AS A BASIC MODEL OF BOAT IN LARGE SEA 4 2014- Present ELECTRICAL BOAT

SSC OR Equivalent School leaving Certificate

MATH, SCIENCE

ENGLISH,ODIA

PRERNA VIDHYA VIHAR HIGH SCHOOL

VAISH TECHNICAL INSTITUTE

INDUS INSTITUTE OF ENGG. AND TECH .

PO

ST. G

RA

D.

DEG

REE

/ D

IP. C

ERTIF

ICATE

WHETHER CERTIFICATE AWARDED

ELECTRICAL BOAT WITH ALTERNATE SOLAR TECHNOLOGY

3

WORK EXPERIENCE

LAST POSITION HELD DESIGNATION NATURE OF DUTIES

SENIOR ENGINEER

TO

AT THE TIME OF JOINING

Employee Code BASIC (P.M.) FIXED (P.A.) VARIABLE (P.A.) GROSS (P.A.)


FROM

NAME & DESIGNATION OF IMMEDIATE SUPERIOR

TO

Employee Code

AT THE TIME OF JOINING LAST DRAWN


FROM


TO

Employee Code



FROM


TO

Employee Code



FROM


TO

Employee Code



FROM


TO

Employee Code


In unbroken chronological order starting from your present employment and ending with first employment (Please account for all the periods of time not covered by education / training) [Please attach extra sheet if required]

EMPLOYER'S NAME & ADDRESS

DURATIONPERIOD(Yrs.)

GROSS EMOLUMENTS Rs. Per month

Details of Current Emoluments
















4

WHAT ARE YOUR SIGNIFICANT ACHIEVEMENTS AND EXPLAIN WHY YOU CONSIDER YOURSELF SUITED FOR THE POSITION :

GEN

ERA

L D

ATA

HAVE YOU EVER BEEN INTERVIEWED BY SHYAM INDUS POWER SOLUTIONS PVT. LTD.?

YES NO DATE/YEAR POSITION COMPANY

RELATIVES / ACQUAINTANCE IN SHYAM INDUS POWER SOLUTIONS PVT. LTD.

NAME RELATIONSHIP POSITION COMPANY & TELEPHONE NOS.

NA

HOW DID YOU COME TO KNOW OF THIS POSITION? BY CAMPUS OF IIET

ARE YOU ENGAGED IN ANY PERSONAL BUSINESS ?

YES NO

YES NO

IF SELECTED, WHEN CAN YOU JOIN?

NAME, ADD., AND TEL Nos. OF TWO SUPERIORS FAMILIAR WITH YOUR WORK (NOT RELATIVES)

NAME COMPANY & POSITION TELEPHONE NOS. E-MAIL ID

HAVE YOU EVER BEEN INVOLVED IN ANY CRIMINAL PROCEEDINGS / CONVICTED OF ANY OFFENCE? IF YES, GIVE DETAILS

DECLARATION UNDER SECTION 314 OF COMPANIES ACT, AS AMENDED IN 1974 (Tick whichever is applicable)

I hereby declare that I am a partner or relative of a Director of the Company

as .

PLACE JIND DATE 4-Jul-16 Applicant's Signature

DRAW IN BRIEF THE ORGANISATION STRUCTURE OF THE COMPANY WHERE YOU ARE PRESENTLY EMPLOYED INDICATING TWO LEVELS ABOVE AND ONE LEVEL BELOW YOUR POSITION (PLEASE ALSO INDICATE THE TOTAL NUMBER OF PERSONS UNDER YOU)

If Yes, give details

if YES, indicate nature of

business

DO YOU HAVE ANY CONTRACT / BOND WITH YOUR PRESENT EMPLOYER? if YES,

Give Details

CR

IMIN

AL

REC

OR

D

I hereby declare that I am not connected with any of the Directors of the Company as his partner or his relative as defined under section 6 of the Companies Act 1956

I declare that the information given above is true to the best of my knowledge. I am aware that any false or incorrect information by me may result in termination of my service with the Company. I have no objection to your inquiring from any of my previous employers on any matters pertaining to me, if I join your Company.

Documents

ASHWANI