BHARAT HEAVY ELECTRICALS LIMITED

Name of Institute :

Please affix a
Programme : B.Tech. B.E. Dual Degree recent Passport
size Photograph

Discipline :

Date of Joining Course : Likely date of completion :

Personal Data

Full Name :
(in block letters) (First Name) (Middle Name) (Surname)

Date of Birth : Category : SC ST OBC

(Please tick, if applicable to you)

Religion : Nationality :

Present Address : Permanent Address :

Pin Code :

Telephone No. with STD Code

Mobile No. e-mail id

(Pl. specify clearly)

Father's Name : Occupation :

Organisation : Designation :
Qualifications
Name of Institute/ Year of CGPA /
Examination Discipline Main Subjects
University passing %age

Graduation (Pl. specify- B.E./ B.Tech/ Dual Degree)

1st year

2nd year

3rd year

4th year

5th year

Maximum Marks/ CGPA : Marks/ CGPA obtained :

Percentage :

Prizes / Scholarships :

Project Work / Dissertation

Title Brief Outline Year

Vocation Training/ Work Experience (if any)

Industry/ Period
Assignment *
Company From To

*(Please give description of the assignment and results achieved)

Extra Curricular Activities :

Special Interests & Hobbies :

Please indicate your choice of places in order of preference : (No. 1 as most preferred)

Bhopal Hardwar Delhi

Hyderabad Jhansi Tiruchirapalli

Bangalore BAP Ranipet IVP Goindwal

HERP Varanasi CFP Rudrapur IP Jagdishpur

Power Sector-Eastern Region Power Sector - Western Region

Power Sector-Southern Region Power Sector - Northern Region
No Preference

Declaration :
I hereby certify that the particulars given herein are true to the best of my knowledge and
belief. If any of this information is found to be false or incomplete, the Company is free to
cancel my selection/ appointment or terminate service contract.

Signature of Candidate Date Place

Recommended Signature of Professor-in-charge

of Placement of Department / Centre

Note : Please furnish any other information that you may wish to, on separate sheet(s) of paper.