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Mazagon Dock LimitedDockyard Road, Mazagon, Mumbai-400 010

REF.NO.MDL / Advertisement No MDL/HR-CR/REC/GATE/2014

APPLICATION FOR THE POST OF Executive Trainee (Mechanical)

To,

GM(HR),

Mazagon Dock Limited

Dockyard Road,

Mazagon, Mumbai-400010.Job Registration Number. : MDL56NKS1J

Name in Full Mr. PRADYUMNA KESHARI NAHAK

Father's Name Mr. KANHU CHARAN NAHAK

Date of Birth 20 Jun 1992 ( Age on 29/Nov/2013 is 21 Years 5 Months 9 Days )

Religion : Hindu Category: General

Physical Disability: OH:No VH:No HH:No % Disability: N.A.

Age Relaxation Sought: NO

Nationality: Indian State of Domicile: Orissa

Gender: Male Marital Status: Unmarried

Are you an Ex-serviceman: No Are you an employee of MDL: No

Correspondence Address: IN FRONT OF HEAD POST OFFICE,MAIN ROAD,PO-JEYPORE

City: JEYPORE

Pin code: 764001 State: Orissa

Contact Number: (Office): (Resi.) :9437068780 (Mobile): 9439916384

Nearest Railway Station: JEYPORE

Personal Email: pradyumnanahak@gmail.com Alternate Email: pjprayash11@gmail.com

Employment ExchangeNo.:

Gate Registration No.: ME604403250

Educational Qualification

Name ofexam/course

University/ Institute/ Board Degree Specialization Date ofPassing

Course Duration

Type ofCourse

Grade %

SSC BOARD OF SECONDARYEDUCATION,ORISSA/SARASWATIVIDYA MANDIRJEYPORE

SSC NA 29 May2007

1 Full Time NA 89.73

HSC COUNCIL OF HIGHERSECONDARYEDUCATION,ORISSA/VIKRAMDEV COLLEGE,JEYPORE

HSC MATHEMATICSPHYSICSCHEMISTRYSTATISTICS

26 May2009

1 Full Time NA 86.67

Diploma /Degree

BIJUPATNAIK UNIVERSITY OFTECHNOLOGY/COLLEGE OFENGINEERING ANDTECHNOLOGY,BHUBANESWAR

B.E. /B.Tech.

MechanicalEngineering

30 Jul2014

4 Full Time APP 77.80

PostGraduation

Full Time

Academic related otherinformation:

Work Experience

Company Name &

Address

Type ofCompany

SalaryBand /

Pay Scale

Designation CurrentEmployer

Duration Job Profile

From To

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Address Pay Scale From To

Work experience relatedother information:

Signature

Declaration

I hereby certify that the above information furnished is correct to the best of my knowledge and belief. I have not suppressed any

material fact or factual information. I also declare that if I do not satisfy the eligibility criteria according to the advertisement , my

candidature will be rejected / services terminated even after permanent employment without giving any notice or reasons thereof.

I hereby certify that I am satisfying the eligibility criteria for the post applied in terms of the required criteria in respect of age,

Educational Qualification, Experience, etc.

SIGNATURE OF THE CANDIDATE

Place : Date : 21/01/2014 02:58:48