UJVN Li mi t ed

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(A Govt. of Uttarakhand Enterprise)
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UJVN Li mi ted
(| l l --
(A Govt. of Uttarakhand Enterprise)


APPLICATION FORMAT-A
(For A.Es(T)

* (Note: Please submit details in Capital letters only)

1 Post Code _____ Name of Post & Branch _________________________

2 Name of candidate:
(Leave one Blank Space)


3 Fathers / Husbands
Name:


4 Date of birth & age as on : Date of birth _________________________

01-07-2011 Age_______Years _______Months _______Day

5 Gender (Please tick) : 1-Male 2-Female

6 Permanent Address: _________________________________________
_________________________________________
_______________________PIN_______________

7 Correspondence Address: _________________________________________

_________________________________________
_________________________________________
_______________________PIN_______________

8 Phone No with STD Code: Office _____________Residence ______________

Fax_______________Mobile _________________
Email ID __________________________________
9 Religion: _________________________________________
10(a) Category: (Gen./SC/ST/OBC) _________________________________________
10(b) Sub-Category: _________________________________________
Ex-serviceman/FF/PH/Woman/Uttarakhand Andolankari.
(Copy of relevant Certificate in prescribed form in reference of Category /Sub Category issued by
the competent authority of Uttarakhand State must be attached).
11 Choice of Examination Centre:
1___________________ 2 ___________________

12 Uttarakhand Domicile (Please tick): 1. Yes 2. No

13 Departmental(UJVNL) Candidate (Please tick): 1. Yes 2. No

14 Signature of Candidate(for Verification/Attendance Sheet)_____________________




Candidates
self attested
Photograph


15 Details of Training under Apprentice Act 1961:-

Name of Organization From To Remarks





16 Details of Educational Qualifications from High School (Matriculation) onwards:


Sl.
No
Examination
passed
Year of
passing
Institute/
Board /
University

Main subjects % of
marks/
Div.
Remarks,
if any














17 Details of experience (in chronological order starting from latest)

Sl.
No
Name of
Organization
Type of
Organization
(Central/State/
PSU/ Pvt.)
Post held Period of
tenure
with date
Brief
description of
duties
Pay,
Scale
Total
emolume
nts drawn















18 Computer proficiency, if any: __________________________________________


19 Details of Bank Draft : Draft No ___________ Amount_________ Date__________

Drawn on Bank ____________________________________


20 Details of any other information: _________________________________________





21. List Of Enclosure (Please attach self-attested copies & Tick ( ) as applicable):

1. Matriculation or equivalent
2. B.E./B.Tech./AMIE (A&B)
3. Mark-sheet of all the above
4. Certificate belonging to category (caste certificate / sub category)
5. Uttarakhand Domicile (as applicable)
6. Apprenticeship training certificate
7. Certificate of experience
8. NOC (as applicable)
9. Bank DD (in original)
10. Any other certificate/document
___________________________________________________________________________


Declaration by the candidate

I hereby declare that all the particulars stated in this application form are true to the best of my
knowledge and belief. I have read the instructions given in the advertisement and I shall abide
by the terms & conditions there-in. In the event of suppression or distortion of any fact, like
category, educational qualification, year of qualifying exam etc, made in my application form.
I understand that I will be denied the opportunity to appear in the Examination and if already
selected, my selection is liable for cancellation. I also understand that the decision of the
UJVNL regarding my selection to UJVNL is final and I shall abide by the decision. Further, if
selected, I promise to abide by the rules & regulations, norms of the UJVNL, on joining.

Place: _________________
Date: _________________ Signature: _____________________

NOTE: All selections are subjected to verification of facts from the original Certificates/
documents of the candidate. If the candidate is found ineligible even at the later date / even
after the selection, his/her selection will be cancelled. The decision of UJVNL regarding the
eligibility shall be final













UJVN Li mi t ed
(| l l --
(A Govt. of Uttarakhand Enterprise)


APPLICATION FORMAT-B
For J.Es(T)
* (Note: Please submit details in Capital letters only)

1 Post Code ____ Name of post & Branch _______________________________

2 Name of candidate:
(Leave one Blank Space)



3 Fathers / Husbands
Name:


4 Date of birth & age as on Date of birth _______________________________

01-07-2011 Age________Years _______Months ________Days


5 Gender (Please tick) : 1-Male 2-Female

6 Permanent Address: __________________________________________
__________________________________________
_______________________PIN________________
7 Correspondence Address: _________________________________________
_________________________________________
__________________________________________
_______________________PIN_______________


8 Phone No with STD Code: Office_____________Residence _______________
Fax _______________Mobile_________________
Email ID __________________________________
9 Religion : _________________________________________
10(a) Category: (Gen./SC/ST/OBC) _________________________________________
10(b) Sub-Category: _________________________________________
Ex-serviceman/FF/PH/Woman /Uttarakhand Andolankari
(Copy of relevant Certificate in prescribed form in reference of Category/Sub
Category issued by the competent authority of Uttarakhand State must be attached).

11 Choice of Examination centre: 1___________________ 2 ____________________

12 Details of Employment: 1-Employment Exchange Name
Exchange Registration _________________________________________
Located in Uttarakhand 2-Registration No. ____________________________
Date of Registration _________________________
Date of Validity ____________________________
13 Uttarakhand Domicile (Please tick): 1. Yes 2. No.
14 Departmental(UJVNL) Candidate (Please tick): 1. Yes 2. No
15 Signature of Candidate(for Verification/Attendance Sheet)______________________






Candidates
self attested
Photograph


16 Details of Training under Apprentice Act 1961:-
Name of Organization From To Remarks





17 Details of Educational Qualifications from High School (Matriculation) onwards :


Sl.
No
Examination
passed
Year of
passing
Institute/
Board /
University

Main subjects % of
marks/
Div
Remarks,
if any
















18 Details of experience (in chronological order starting from latest)


Sl.
No
Name of
Organisation
Type of
Organisation
(Central/State
/PSU/ Pvt.)
Post held Period of
tenure
with date
Brief
description of
duties
Pay scale
and total
emolume
nts drawn

















19 Computer proficiency, if any: _________________________________________

20 Details of Bank Draft Draft No _________ Amount _________Date__________

Drawn on Bank__________________________________


21 Details of any other information :_________________________________________

22. List Of Enclosure (Please attach self-attested copies & Tick ( ) as applicable):

1. Matriculation or equivalent
2. Diploma
3. Mark-sheet of all the above
4. Certificate belonging to category (caste certificate / sub category)
5. Domicile certificate of Uttarakhand(as applicable)
6. Employment exchange registration certificate
7. Apprenticeship training certificate
8. Certificate of experience
9. NOC (as applicable)
10. Bank DD (in original)
11. Any other certificate/document
__________________________________________________________________________


Declaration by the candidate

I hereby declare that all the particulars stated in this application form are true to the best of my
knowledge and belief. I have read the instructions given in the advertisement and I shall abide
by the terms & conditions there-in. In the event of suppression or distortion of any fact, like
category, educational qualification, year of qualifying exam etc, made in my application form.
I understand that I will be denied the opportunity to appear in the Examination and if already
selected, my selection is liable for cancellation. I also understand that the decision of the
UJVNL regarding my selection to UJVNL is final and I shall abide by the decision. Further, if
selected, I promise to abide by the rules & regulations, norms of the UJVNL, on joining.

Place: _________________
Date: _________________ Signature: _____________________

NOTE: All selections are subjected to verification of facts from the original Certificates/
documents of the candidate. If the candidate is found ineligible even at the later date / even
after the selection, his/her selection will be cancelled. The decision of UJVNL regarding the
eligibility shall be final