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APPLICATION FORM FOR NALCO GET/MT-2010

Personal Details

Registration No: 2028218

Post applied for GET Please affixyour selfattested

passport size

photoName of the test city Bangalore

Language for written test English

Name of the Discipline Metallurgy

Indicate Category to which youbelong

OBCIndicate if you belong to PWD

No

No Percentage of DisabilityDate of Birth Saturday, February 18, 1984

Age relaxation claimed

NoOBC

Name ofCaste/Communit

yDate ofIssuing

Caste Cert.State of

Origin/Domicle

Caste Cert.Issuing

AuthorityBANIYA 21/7/2010 BIHAR S.D.O..

Details if domiciled in KashmirDivision during the period from01/01/1980 to 31/12/1989

No

Nationality INDIANSex Male

Marital Status UnMarried

Name (in Block Letters) KRISHNA KUMAR

Address for Communication

Address E-BLOCK, ROOM NO:47, STUDENTS HOSTEL,

INDIAN INSTITUTE OF SCIENCE

BANGALORE

State KarnatakaPin 560012

Father's Name RAMANAND GUPTA

Nearest Railway Station (frommailing address mentionedabove)

YESHWANTPUR

Contact Details

Contact No 9608533262 (Mobile)

(Land Line with STD code)

Email Id (All information will be

in this id) krish2k6bit@gmail.comAlternate Email Id (Optional)

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Qualification Information

ONLY FOR GRADUATE ENGINEER TRAINEES(GETs)Educational Qualification: (Mention only the prescribed Qualification which makes you eligible i.e. BachelorDegree in Engineering/Technology)

ExaminationPassed/ Appeared/

AppearingName of the

UniversityDisciplinerelevant to

GETType of

CourseMonth of

passingYear of

passingPercentage of Marksupto 2 decimal places in

aggregate of allyears/semesters

Passed V.B.UHAZARIBAGH

Metallurgy BTech June 2010 74

Management Degree if any (GETs): No

Mtech Degree if any (GETs): No

DeclarationI hereby declare that all statements made in the application are true, complete and correct to the

best of my knowledge and belief. In the event of any information being found false or incorrect at any

point of time, my candidature/appointment may be cancelled/terminated without any notice. I also declarethat I am a citizen of India by birth/domicile.I understand that my application will be provisionally considered if and if this application form dulycompleted along with self attested photograph and requisite NALCOs copy of pay-in-slip in original withbank seal is received at Post Box No. 12026, Cossipore Post Office, Kolkata-700002 on or before07/09/2010 . Additionally if I belong to SC/ST/OBC(non-creamy layer)/PWD/J&K Domicile candidate; then I

am also enclosing a self attested copy of relevant certificate along with above-mentioned items.Place............................

________________________________Signature of the Candidate

Date.............................

Advt.No