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REGISTERED ONLINE APPLICATION FORM FOR GRADUATE ENGINEER TRAINEE

To Sr.DGM (Recruitment), Personnel Group, ECIL (P.O) Hyderabad-500062.

With reference to your advertisement, I hereby submit my Application on 2011-07-29 07:19:27. Adver i ent tsem No : Applcaton No : i i 6/2011 Post Nam e : GET Cat egor : y Exam i i Cent e naton r pr er ed : ef r Engi neerng Br i anch : CHENNAI

1187621

OBC

ELECTRICAL

Personal Details : Nam e : Fat ' Nam e : hers Gender : I Per f son w ih Di lt : t sabiiy Dat of Bit : e rh Natonalt : i iy St e of Dom i l : at cie M ot Tongue : her M obie No : l JAGAN R RAMASAMY Male No 1989-04-27 Indian TAMIL NADU TAMIL 9659102082 M art St us : ial at PHType and % : Age as on 2011- 30 : 06Relgi : i on Near Rl St : est y n Languages know n : E- ai I : m ld 22 Yrs 2 Mths HINDU THIRUPPAPULIYUR ENGLISH, TAMIL jaganxyz@gmail.com Single

W het dom i l ( esi her cied r ded) i t St e ofJam m u & Kashm i bet een 01/ 1980 No n he at r w 01/ and 31/ 1989 : 12/ Address for Correspondence : 48 GANDHI NAGAR, SECOND CROSS CUDDALORE - 607001 , TAMIL NADU Phone Num ber w ih STD Code) : ( t Permanent Address : 04142 - 292177 48 GANDHI NAGAR, SECOND CROSS CUDDALORE - 607001 , TAMIL NADU Phone Num ber w ih STD Code) : ( t 04142 - 292177

Details of the SBI Pay-in-Slip (Not Applicable for SC/ ST/ PWD categories) : Br anch Code : Jour No : nal 4891 12016056 Nam e oft Br he anch : Dat ,Am ount : e MANJAKUPPAM 2011-07-28 , 200/Continued Page 2...

https://ecil.gov.in/app/applform_get_print.php

8/8/2011

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Percentage of Marks Secured in the Engineering Degree : 71.51 %


Qualifications : Sno Q ualfcaton ii i 1 2 3 BE - EEE XII STANDARD X STANDARD I iuton/ l nstt i Colege SHRI ANDAL ALAGAR COLLEGE OF ENGINEERING A.R.L.M MATRICULATION HIGHER SECONDARY SCHOOL A.R.L.M MATRICULATION HIGHER SECONDARY SCHOOL Boar Uni siy d/ ver t ANNA UNIVERSITY STATE BOARD % M ar ks 71.51 82.50 Cl ass M M / Year 1st 1st 1st 05/2011 03/2007 03/2005

MATRICULATION 80.63

Summary of the Skill Set / any other relevant information : 1. ACTIVE MEMBER OF N.S.S 2. AWARDED CERTIFICATE A BY DIRECTORATE OF SCHOOL EDUCATION 3. PARTICIPATED IN NPTEL WORKSHOP AT IIT MADRAS

Reference of any two persons and their addresses along with Telephone / Mobile Nos, who known you personally atleast for Six months at the time of applying : The following documents are enclosed (to be submitted at the time of Interview) : 1. Online Application Form duly Signed and Affixed with recent colour passport size photograph. 2. Photo copies / attested copies of Age Proof as per Matriculation certificate. 3. Photo copies / attested copies of all Educational Qualifications with memorandum of marks. 4. Photo copies / attested copies of latest Caste Certificate issued by Competent Authority (For SC/ST/OBC Categories). 5. Photo copies / attested copies of latest Physical Disability Certificate issued by Competent Authority (For PWD Category). 6. Hall Ticket (Candidate's Copy) duly attested by Invigilator. 7. J & K Domicile Certificate issued by Competent Authority wherever applicable. DECLARATION : I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. I am aware that in the event of any of above information found to be false, my candidature / appointment for the said post is liable to be terminated at any stage of service. Further I declare that I have never been arrested/ prosecuted and convicted by a criminal court or involved in any other case registered with police. In case Final Result of the Required Qualification is awaited at the time of submitting online application, Degree/ Provisional/ Consolidated Marks Memo would be submitted at the time of attending Interview. In the event of non-submission of the same by Interview date, I am aware that my candidature will be canceled. I have read all the Instructions completely and will abide by them.

Place : Date : Signature of the Applicant

https://ecil.gov.in/app/applform_get_print.php

8/8/2011