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APPLICANT FORM

Confidential PHOTO
Corporate Office: Ceat Mahal, 463, Dr. Annie Besant Road, Worli, Mumbai 400 025; www.kecrpg.com

(1)PERSONAL DETAILS
FULL NAME: E-MAIL:
Dipak Bhole Vijay dipakb1981@gmail.com
(FIRST NAME SURNAME FATHER’S NAME)

PRESENT ADDRESS:
05/201, ‘Orchid’, Regency Estate, Kalyan Shil Road, Near Jondhale Engg. College, Dombivli-East
PIN CODE:421306
City: State: Residence No: MOBILE No.
Dombivli Maharashtra
9223505391
PERMANENT ADDRESS: Same as above
PIN CODE:
City: State: Residence No: MOBILE No.
DATE OF BIRTH (dd/mm/yy): AGE COMPLETED(In years): MARITAL STATUS: Single
28/05/1981 29
NO. OF CHILDREN/AGES: - OTHER DEPENDANTS: Mother & Father
LANGUAGES KNOWN: Marathi, English, Hindi
INTERESTED IN WORKING OVERSEAS? YES__ NO__
If Yes, tick preferences: ANY__ Afghanistan__ Abu Dhabi __ Algeria__ Kenya__ Kazakhstan__ Libya__
Nigeria__ Saudi Arabia__ Congo__ Any others (please mention):
NATIONALITY: PASSPORT: YES If yes, VALID
Indian UPTO:17/04/2017
CASTE (SCHEDULED CASTE/TRIBE/OBC/OTHERS): OBC SUB-CASTE: Leva Patidar
PERSON TO BE NOTIFIED IN EMERGENCY: Rahul Bhole Contact No.09920538199
(3)EDUCATION Please begin with the highest qualification
EXAMINATION MONTH & UNIVERSITY/ %/CGPA SPECIAL SUBJECTS
PASSED YEAR OF INSTITUTE OBTAINE
PASSING (School/College) & D
Location
BE in Electrical Engg May 2003 Pune University First Class Electrical
Diploma in Electrical May 2000 MSBTE First Class Electrical Power System
Power System
Diploma in Electrical May 1999 KJ Somaiya Polytechnic Second Electrical
Engg. (Autonomous) Class
SSC May 2006 Mumbai Board Distinctio Marathi, English, Science
n

(2)PRESENT EMPLOYMENT
DESIGNATION Assistant Manager
NAME OF PRESENT TATA Communications
EMPLOYER JOINED ON January 2007

OFFICE PHONE

DRAW A BRIEF -Procurement of major


YOUR CURRENT Electrical equipments such
DEPARTMENT RESPONSIBILI
as HT & LT Panels, DG set,
STRUCTURE TIES
Transformers, UPS, and PDU,
Battery for Data centre
projects.
(1)PREVIOUS EMPLOYMENT

Total Experience: Seven Years

(2)ADDITIONAL INFORMATION

NAME DESIGNATION RELATIONSHIP WITH


ANY RELATIVE/FRIENDS YOU
EMPLOYED IN OUR CO.?
IF “YES” PLEASE GIVE SUPE
DETAILS: RVISO YOUR DURATION SALARY
(4)PROFESSIONAL REFERENCES
FULL NAME OF EMP RS DESIGNATI DRAWN
REASON
CODE/ NAME ON (Per
FOR
EMPLOYER Name
Reference with PERSON Company
& & FROM
Period Contact Annum) Referred
of TO (Month/
NEL NO CHANGE
LOCATION CONT (Month/ Year)
capacity
ACT at which working
Year)
details of persons
worked
NUMBtogether? together? referred current
ERS person Organization
Mukand Engineers Jr. Manager May Dec. 2006provide
(Please Rs.2,20,000/ & Better
Limited 2004 LAND LINE & - Designation
prospects
MOBILE.)
Senior's Reference
Jaywant Kolte TATA Communications 4 Year 08097976677 TATA
Communication
Aditya Vidyut Trainee Dec 2003 April 2004 Rs. 30,000/-
s Better
Appliance Ltd. Engineer prospects
Designation-
Deputy General
Manager
Commercial
Dharmesh Bhatt TATA Communications 3 Year 08097003636 TATA
Communication
s
Designation- Sr.
Manager
Commercial

Peer's Reference

Chetan Mangale Manager Commercial 3 Year 08097009970 TATA


Communication
s
Designation-
Manager
Commercial

Subordinate’s Reference
I consent to take any pre or post-employment examinations and or verification/checks as may be required by KEC
INTERNATIONAL or its representative. AND I, the applicant confirm that the aforesaid entries filled by me are true. I agree that I am
liable to be dismissed without any notice if any of these entries is found to be wrong or false.

DATE: SIGNATURE:

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