OIL AND NATURAL GAS CORPORATION LTD. ONGC ACADEMY Kaulagarh Road,Dehradun -248195 . Fax No: 0135 -2758832 Dated: July 4, 2018 Dissertation by Post-Graduate Students in ONGC The students pursuing Post-graduate courses in the upstream petroleum related subjects may apply in prescribed form for carrying out their dissertation work in ONGC during their final year. The duration of Dissertation work in ONGC will be of minimum 6 months on continuous basis during October 2018 to June 2019. The application(s) complete in all respect should accompany with a forwarding letter by the Head of Department requesting ONGC for the dissertation work of student(s). The letter of Head of Department should be addressed to Head , ONGC Academy, 9, Kaulagarh Road, Dehradun- 248195 . The letter should state that carrying out the dissertation work in industry is a requirement of the course curriculum and should have the following information: Sl Name of student Name of course Year of course Duration of dissertation in ONGC (from month to month) Area of interest for dissertation ONGC institute / work centre Relative Merit position Last date of receiving applications in ONGC Academy Dehradun is 31st August, 2018 The letter of Head of Department and the application(s) in the prescribed form should be sent to: Head ONGC Academy 9, Kaulagarh Road DEHRADUN-248195 (Uttarakhand)

OIL AND NATURAL GAS CORPORATION LTD. ONGC ACADEMY, Dehradun Application for Dissertation work by post-graduate students pursuing M.Tech./ M.Sc. courses in upstream petroleum related disciplines (To be filled in by the Applicant) Name (in capital letters): Date of Birth: Gender: F/M ( any One) Category: Gen/SC/ST/OBC/Others Address: PIN

Mobile No. + 91

E-mail:

Bank Details (Applicant):

Name of Bank:

Account No:

IFSC Code:

PAN Card No.:

Father/Mothers Name and Address:

If Father / Mother Employee of ONGC:

Designation: CPF No:

Location: Mobile:

Academic Details:

Name & Address of the present academic institute:

Name of the present course:

Subject of interest for dissertation work:

Present semester / year:

Marks: (a) Last semester / year %: (b) % in 10+2: (Attach proof).

I______________________________________ son /daughter of ________________________________request ONGC for granting me the permission to undertake dissertation work at ONGC. I have not undertaken dissertation work in ONGC before. Date (Signature of Applicant)

Recommended for Dissertation Work in ONGC (Signature and Seal) Head of Department of the Academic Institution

Title of the project (As identified by Key Executive): ___________________________________________

______________________________________________________________________________________

Synopsis of the project: Separate sheet to be attached

Name of the Mentor____________________________Designation_______________CPF No.__________

Recommendation of Key Executive of Institute/Asset/Basin: ____________________________________

_____________________________________________________________________________________

Signature of Key Executive

______________________________________________________________________________________

Approved / Not Approved

Date: Signature of HOI-ONGCA

______________________________________________________________________________________

Electronic Clearing Service (Credit clearing)

(Model Mandate Form)

(Investor/customers option to receive payments through Credit clearing mechanism)

(Scheme name and the periodicity of payment)

Vendor No.

1. INVESTOR/CUSTOMERS NAME:

2. PARTICULARS OF BANK ACCOUNT:

A. BANK NAME

B. BRANCH NAME

Address

Telephone No.

C. 9-DIGIT CODE NUMBER OF THE BANK & BRANCH:

(Appearing on the MICR Cheque issued by the bank)

C.1. IFSC/NEFT/RTGS CODE OF BANK:

D. ACCOUNT TYPE:

(SB Account/Current Account or Cash Credit with Code 10/11/13)

E. LEDGER NUMBER/LEDGER FOLIO NO.

F. ACCOUNT NUMBER

(As appearing on the Cheque Book)

( In lieu of the bank certificate to be obtained as under, please attach a blank cancelled Cheque or photocopy of a Cheque or front page of your savings bank passbook issued by your bank for verification of the above particulars)

3. DATE OF EFFECT

I hereby declare that the particulars given above are correct and complete. If the transaction is delayed or not effected at all for reasons of incomplete or incorrect information, I would not hold the user institution responsible. I have read the option invitation letter and agree to discharge responsibility expected of me as a participant under the scheme.

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Date: Signature of the Investor/Customer

Certified that the particulars furnished above are correct as per our records.

(Banks Stamp)

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Signature of the Authorized

Official from the Bank

Date: