NBCC (INDIA) LTD.

Application No.(FOR OFFICE USE)

(A Govt. of India Enterprise)

(Formerly Known as National Buildings Construction Corporation Ltd.)

Photo

Application for the Post of __________________________________

Advt No. 09/2018

1

Name (IN BLOCK LETTERS)

2

Father's / Husband's Name

3

E-Mail Id:

4

Gender

5

Date of Birth (dd/mm/yyyy)

6

Age as on Closing date of application ( 27.07.2018)

7

Marital status

8

Religion

9

Nationality

10

Category (Please tick a) Enclose copy of certificate in case of SC/ST/OBC (Non Creamy Layer)

GENERAL

OBC (Non Creamy Layer)

SC

ST

11

Whether the candidate is Physically Challenged? (Please tick a)

Yes:

No:

12

If yes, nature of Handicap & percentage of disability

OH

HH

VH

Disability: ____________%age

13

Whether the candidate is an Ex-Serviceman? (Please tick a)

Yes:

No:

14

Address (Please give full postal address with Postal Pin No)

Present Mailing Address:

Permanent Address:

State: Pin:

State: Pin:

Contact No:

Contact No:

15

Educational Qualifications in Chronological Order:

%age of Marks

Name of Course/ Degree or Examination passed

Whether fulltime / part time / Correspondence

Month & Year of Passing

Name of Board/ Institution/ University

Duration of Course

* date of declaration of result / date of issue of final semester mark sheet/provisional certificate / degree, whichever is earlier will be considered as the date of passing the examination.

16

Details of Post Qualification Experience _______ Yrs (In chronological order)

S. No

Name of the organization (Full name with address)

Post held

Period (Exact dates to be given)

Job Description in brief

Pay Scale/ Salary Drawn

Reason for Leaving

To

Total Period

From

Years

Months

If selected, period of notice required to join ___________________________________

Icertify,thattheinformationfurnishedaboveistrue,completeandcorrecttothebestofmyknowledge&belief.Ifatanystage,anyinformationisfoundtobefalseorincorrect,mycandidature may be cancelled and my appointment if made, shall stand terminated without any notice and compensation

Place:

Date:

Signature of Applicant

For Official Use

Eligible

Not Eligible

Reasons for Non Eligibility ; .

Place:

Date:

Signature of Dealing Officer/Executive