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ueZnk gkbMªksbySfDVªd MsosyiesaV dkjiksjs’ku fyfeVsM
¼ ,u,pihlh ,oa e0iz0 ‘kklu dk la;qDr miØe½
fuxe eq[;ky;] ,u,pMhlh ifjlj] ‘;keyk fgYl]] Hkksiky ¼e0iz0½&462013
Narmada Hydroelectric Development Corporation Ltd
(A JV of NHPC & Govt of MP)
Corporate Office, NHDC Parisar, Shamla Hills, Bhopal (MP) -462013.

vkosnu izi=@Application Format

foKkiu la[;k@Advertisement No……… vkosfnr in@Post Applied……………….

xzsM@Grade …………………….. osrueku@Pay Scale……………………

1. vkosnd dk izFke uke@Applicant’s First Name e/;uke@Middle Name vafre uke@Last Name

2. firk@ifr dk uke@Father’s/Husband’s Name

3. tUefrfFk ¼fnu@ekg@o”kZ½@Date of Birth (dd/mm/yyyy)

4. ------------------- dks vk;q@Age as on .-------------------

o”kZ@Year ekg@Month fnu@Days

5. i=kpkj dk irk@Postal Address

laidZ irk@Communication Address

‘kgj@City ftyk@District jkT;@State

fiu dksM@Pin code ,lVhMh@{ks= dksM@STD/Area Code nwj nwjHkk”k@Phone

Øekad@Number

fudVre jsyos LVs’ku@

Nearest Railway Station

6. LFkk;h irk@Permanent Address

‘kgj@City ftyk@District jkT;@State

fiudksM@Pin code ,lVhMh@{ks= dksM@STD/Area Code nwjHkk”k@Phone

Øekad@Number

eksckby u0@Mobile No. esy vkbZMh@Mail-Id

fudVre jsyos LVs’ku@

Nearest Railway Station
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7. vU; lwpuk@Other Information

oSokfgd fLFkfr@Marital Status /keZ@Religion fyax@Gender

Js.kh ¼,lh@,lVh½@Category (SC/ST) mitkfr@Sub Caste

fodykax dk izdkj@Nature of PH vf/kokl@Domicile

HkwriwoZ lsU;lsok dk fooj.k@Details of Ex-serviceman

tkjhdÙkkZ izkf/kdkjh@Issuing Authority izek.ki= la[;k@Certificate No. oS?krk@Validity

8. ‘kSf{kd@rduhdh@O;kolkf;d ;ksX;rk,a@EDUCATIONAL / TECHNICAL/ PROFESSIONAL

QUALIFICATIONS
¼vafre mRrh.kZ ijh{kk ls izkjEHk djsa A ;fn vko’;drk gks vyx ls ‘khV yxk;sa½
(Start with the last examination passed. Attach separate sheet if needed)

Ø-la-@ mRrh.kZ ijh{kk@ mRrh.kZ o”kZ@ vof/k@ fo”k;@fof’k”VRkk Js.kh@ izfr’kr@ cksMZ@fo-fo-
S.No. Exam Passed Passed Duration @Subjects/ Division Percentage @laLFkku@
Year Specialisation Board /
Uni./Inst.

9. Kkr Hkk”kk,a@LANGUAGE KNOWN

¼d`i;k fpfUg~r djsa½@¼Please put tick mark)

Hkk”kk@Language i<+uk@Read fy[kuk@Write cksyuk@Speak

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10. jkstxkj fooj.k@EMPLOYMENT PARTICULARS
¼orZeku fLFkfr ls ihNs dh vksj vojksgh Øekuqlkj] ;fn vko’;drk gks vyx ls ‘khV yxk;sa½
(In Chronological Order starting from present position backward. Attach separate sheet if needed)
lk-{ks-m-@ laxBu dk uke ,oa lsok dh vof/k@Period of Service
dsUnz@jkT; irk@ dk;Z dh izd`fr@
ljdkj@futh@ dqy vuqHko@ inuke@ osrueku@
Name of rd@ Nature of
PSU/ Central / ls@From Total Designation Pay Scale
State Govt / Organization & To Duties
PVT Address Experience

b. fu/kkZfjr frfFk dks ;ksX;rk i'pkr vuqHko dh vof/k@ o"kZ@Year ekg@Month fnol@Days
Length of Post Qualification experience as on due date:

c. orZeku osru¼ewy osru½@Present Salary (Basic Pay) Mh-,[email protected] vU; HkRrs@Other Allowance.

dqy osru@Total Pay

11- izf’k{k.k@laxks”Bh@lsehukj@ikB~;Øe ftles lfEefyr gq,@TRAINING/SEMINARS/COURSES ATTENDED

¼vafre ls izkjaHk djsa½@ (Start with the last one)
Ø-la-@ ikB~;Øe lsehukj dk uke@ vof/k@ laLFkku dk uke@
S.No. Name of the Course/Seminar Duration Name of Institution

12. vkosnu ‘kqYd dk fooj.k¼;fn ykxw gks½@Details of Application Fee :- (If Applicable)
MhMh@cSadj dk psd u-@ tkjh frfFk jkf’k :0@ tkjhdrkZ ‘kk[kk dk uke@
DD / Banker’s Cheque No Issue Date Amount Rs. Address of Issuing Branch

13. pkgk x;k U;wure dk;ZHkkj xzg.k djus dk le;@Minimum Joining time required
¼p;u dh fLFkfr esa½@ (In the event of selection)
14. dksbZ vU; lwpuk@Any other Information

?kks”k.kk@Declaration:-
eSa ,rn~ }kjk ?kks”k.kk djrk gw¡ fd esjs }kjk nh x;h mi;qZDr lHkh tkudkjh lR;] ‘kq) ,oa lHkh n`f”V;ksa ls iw.kZZ gSa A eSa fcuk fdlh iwokZxzg
ds bl ckr dh lgefr o Lohd`fr nsrk gw¡ fd fdlh Hkh le; ;fn dksbZ Hkh fooj.k vlR; ik;k tkrk gS rks esjh mEehnokjh ,oa @vFkok esjh
fu;qfDr fcuk fdlh lwpuk ds fujLr dj nh tk;s@ I hereby declare that the particulars furnished by me are true, correct and
complete in all respects. I agree & accept without any reservation that at any time, if any of the particulars is found to
be incorrect, my candidature and /or my appointment may be terminated without notice.

layXuksa dh lwph@List of Enclosures:-

vH;FkhZ ds gLrk{kj@
Signature of the Candidate
fnukad@Date:-
LFkku@Place:-