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-- :: Application Form For Employment :: --

Registration No. : 142108

I. POSITION DETAILS
Name of Post Pay scale Grade : : : EXEC UTIVE TRAINEE (MEC HANIC AL) Rs. 24900-50500 E2

II. PERSONAL DETAILS

1. GATE-2014 Registration Number (Enter GATE-2014 Registration No. which is mentioned on your GATE-2014 admit card )

ME401304367

2. Name (Name should be filled up as appearing in your GATE 2014 admit card)

C andidate's full Name

SUNNY KUMAR

3. Date of Birth

14/04/1990

4. Father's Name 5. Category 6. Name of Caste / Tribe (In case of SC/ST/OBC) 7. Other Category, If Applicable (i) (ii) (iii) Persons with disabilities Ex-Serviceman Domiciled in J&K between 01.01.1980 and 31.12.1989

: : :

S P PAUL OBC (NON C REAMY LAYER ONLY) SHEPHERD

: : :

NO NO NO

8. Details (In case of PWD) (i) (ii) Type of Disability Percentage (%) of Disability : : NA 0

9. Details (In case of Ex-Serviceman) (i) (ii) (iii) (iv) (v) (vi) (vii) Rank C orps / Regiment Number Date of C ommission Date of Discharge Date of start of pre-commission training, if any Education of Military Length of service : : : : : : : NA NA NA NA NA NA 0 YEAR(S) 0 MONTH(S) 0 DAY(S)

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10. Nationality 11. Religion 12. Sex 13. Marital Status 14. Present Postal Address (i) (ii) (iii) (iv) (v) (vi) (vii) 1st Address Line 2nd Address Line 3nd Address Line C ity District State PIN C ode

-- :: Application Form For Employment :: -: : : : INDIAN HINDUISM MALE SINGLE

: : : : : : : : : :

S/O-S P PAUL NEAR LIFELINE C LINIC MOHALLA-SHIVGANJ DEHRI ON SONE ROHTAS BIHAR 821307 STD C ode: 0 0 SUNNY_14490@REDIFFMAIL.C OM Number: 0

(viii) Telephone (Landline) (ix) Telephone (Mobile)

15. Present e-mail Address

III. Education & Experience Details

1. Essential Qualification Details :

Examination / Branch/Discipline/Specialization Degree Passed SSC (10th) HSC (10+2) BE / B TEC H / BSc(ENGG) ALL MATHS MEC HANIC AL

C ollege / Institution MODEL SC HOOL MODEL SC HOOL ANNAMALAI UNIVERSITY

Year of Joining 2004 2006 2008

Year of Passing 2005 2007 2012

Board / University C BSE C BSE ANNAMALAI UNIVERSITY

Percentage of Marks * 69.6 60.4 85.7

Type FULL TIME FULL TIME FULL TIME

* Percentage of marks to be calculated taking average of all semesters/ years, irrespective of the weightages given to any particular semester/ year by the Institute/ University. Wherever, C GPA/ OGPA or letter Grade in a Degree is awarded, equivalent percentage of marks should be indicated in the application as per norms adopted by University/ Institute. C andidates currently in the final year (2013-14) of their Engineering Degree course should indicate percentage of marks received in aggregate up to the last semester examination at the time of applying.

2. Post Qualification Work Experience Details : I. Do You have any post qualification work experience : NO

II. C urrent / Last C ompany Name

NA

III. From Date (DD/MM/YYYY)

NA

IV. To Date (DD/MM/YYYY)

NA

IV. DECLARATION
I certify that a) I am not employed in Govt. /Statutory Organization /Public Sector Undertaking.

b) In case of my employment in Government / Statutory Organization / Public Sector Undertaking, I will produce No Objection C ertificate (NOC ) from my organization at the time of Interview, if called for.

I declare that all information given in this application form are true to the best of my knowledge and belief. If any of

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-- :: Application Form For Employment :: --

the information is found incorrect or distorted at any stage, I shall have no objection to cancellation of my candidature.

SUNNY KUMAR (Name & Signature) Date: 30/12/2013

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