GAIL (INDIA) LIMITED

(A Government of India UndertakingA Maharatna Company)

Please affix your recent passport size colour photograph

APPLICATION FORM FOR EMPLOYMENT

I. POST DETAILS Post applied for Pay Scale Grade : : :

II. PERSONAL DETAILS (in BLOCK letters) 1. 2. 3. 4. 5. 6. 7. First Name Middle Name Last Name Date of Birth (DD/MM/YYYY) Fathers/ Spouses Name Category (Tick in appropriate box) Name of the Caste/ Tribe (In case of SC/ ST/ OBC (NCL)) : 8. Other Category, If Applicable (Tick in appropriate box) (i) Persons with Disabilities : (ii) (iii) Ex-Serviceman Domiciled in J&K
YES NO

: : : : : : SC
ST
OBC (NCL) GEN

YES YES

NO NO

between 01.01.80 & 31.12.89 :

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9.

Details (In case of PWD) (Tick in appropriate box) (i) Type of Disability (ii)

OH

VH

HH

Percentage (%) of Disability

10.

Details (In case of Ex-serviceman) (i) (ii) (iii) (iv) (iv) Rank :

Corps/ Regiment Number : Date of Commission Date of Discharge Date of start of precommissioning training, if any : : :

(vi) (vii) 11. 12. 13. 14. 15.

Education of Military Length of service

: : : : : : Permanent Address
MALE FEMALE

Nationality Religion Sex Marital Status Present Postal Address

(i) (ii) 16.

Telephone (Landline) Telephone (Mobile)

: STD CODE : : :

Number :

Present E-mail Id.

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III.

EDUCATIONAL DETAILS (10th onwards)

Branch/ School/ Year of Year Board / Percentage Mode Discipline College/ Joining of University of Marks (Full time Institution Passing obtained / Part time / Distance Mode)

Exam / Degree Passed

IV. PARTICULARS OF POST QUALIFICATION RELEVANT EXPERIENCE

Name of Type of Organisati Industry on/ Company Location Employment period From To Post held Pay Scale From Pay Details Pay Scale To Basic Pay Total Pay P.M. Nature of Jobs

* Separate row should be used for experience in case of change in grade/ designation due to promotion in the same company
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[Please provide details of experience starting from the present Job. In case you have served at different positions (on account of promotion in a particular organization, then, please give details of different positions held in that organization with dates and Pay Scales] V. HAVE YOU APPLIED IN GAIL DURING THE LAST TWO YEARS:

VI.

List of the Documents/ testimonials attached in support of age, category, qualification, experience etc.

VII. APPLICATION FEE DETAILS Details of application fee paid (if applicable) Bank Name Branch Name City Date Amount Demand Draft No./ Bankers Check. No.

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VIII. DECLARATION I Certify that1. I am/ I am not employed in Govt./ Statutory Organization/ Public Sector Undertaking. 2. In case of my employment in Govt./ Statutory Organization/ Public Sector Undertaking, I will produce NOC or forwarding letter from my present Organization at the time of Test/ Interview. I declared that all information given in this application form are true to the best of my knowledge and belief. If any of the information is found to be incorrect or distorted at any stage, I shall have no objection to cancellation of my candidature.

Date: (Name & Signature)

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