Post: Deputy Company Secretary (E-IV Grade) BHARAT ELECTRONICS LIMITED (CORPORATE OFFICE) Affix your photograph

1.

Name in full : (Mr./Ms.) (As per SSLC certificate)

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2.

Age as on 01.05.2017 & Date of birth

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3.

Sex: M/F

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4.

Marital Status

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5.

Father’s Name

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6.

Nationality

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7.

Category-General/SC/ST/OBC

: OH VH HH

8.

Category of Disability

:

9.

Percentage of Disability as indicated in the disability certificate (Enclose Certificate in the prescribed format)

10.

Religion: Hindu / Muslim / Christian / Sikh : / Neo-Buddhist / Zorastrian, others (please specify)

11.

Hobbies / Special Interests

12.

Whether participated in NCC/Scouts/Cultural activities/Debate/: Competition / Sports etc. (Please specify)

13.

Qualification: (Academic / Professional) (indicate division & year of passing)

Educational status from SSLC onwards

Institution/ University

Year Studied from to

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Languages Studied

Class secured/ Percentage of marks

Medium (Hindi/English)

14.

Are you employed in Govt./PSU/Quasi Govt., if yes, have you enclosed NOC? Yes/No

15.

Details of Experience : (Start with current employment) If any:

Sl. No.

16.

Name of the Organisation

From

To

Designation

Nature of responsibilities in brief

Salary Drawn (Please furnish details of all components like Basic, DA, HRA, CCA including pay scale etc)

17. Address with Pin Code a) Permanent Address

Phone No: (c) e- mail id

Phone No: :

Details of DD payment: 18.

b) Correspondence Address

d) Mobile Ph No:

DD NO : ___________ DD Date___________

Undertaking I affirm that the information given above is true and correct . I further declare that if any at stage it is discovered that an attempt has been made by me to willfully conceal or misrepresent facts, my candidature may be summarily rejected or my employment terminated.

SIGNATURE OF THE CANDIDATE Date: Place: