iocl_822588.pdf

Indian Oil Corporation Limited (A Government Of India Undertaking) Application form (Personal & Confidential) Please take the print out of the application form in A4 size portrait format only GATE Reg. No. # : EC-77053S1089 Indianoil Reg. No.# : 822588 Paste your recent self attested Passport size photograph and it should be the same as submitted along with GATE Application form Date : 25-12-2014 Post Applied : Officer/ Engineer Candidate's Name : Mr.VIKAS P S Father's / Husband's Name : POOMALAI P Relationship : Father Date of Birth :13-08-1993 Gender : Male Choice for Interview Centre : Chennai Contact No : 9710938012 , 044-23643615 Email Id : [email protected] Alternate Email Id : [email protected] Are You presently in Employment with IOCL : No Category : Gen State of Origin / Domicile : TAMILNADU Religion : Hindu Whether belong persons with Disabilities(PWD)? : No Whether Ex-Serviceman : No Domiciled in JK (between 01.01.1980 and 31.12.1989) : No Marital Status : Unmarried Discipline Applied For : Electronics & Communication Engineering Discipline Code : EC Educational Qualification Details Name of Degree : B.E. Branch / Name of the Course : Electronics & Communication Engineering Course Duration : 4 Y - 0M Whether Full time Regular Course : Yes whether Completed : No If Result Awaited expected to be announce in Month of result : May -2015 College / Institution Name : COLLEGE OF ENGINEERING GUINDY ANNA UNIVERSITY Name of Affiliate University : Course Approved by AICTE : Yes Address for Correspondence Address1 : JAINS AASHIANA G-11 PHASE-I Address2 : NO 13 VEMBULIAMMAN KOIL ST City / Town : WEST KK NAGAR CHENNAI State : TAMILNADU Pincode : 600078 Permanent Address if different from above Address1 : JAINS AASHIANA G-11 PHASE-I Address1 : NO 13 VEMBULIAMMAN KOIL ST City / Town : WEST KK NAGAR CHENNAI State : TAMILNADU Pincode : 600078 Nearest Railway station : GUINDY All the information given in this application form are true to the best of my knowledge and belief. If any of the information is found incorrect, my candidature may be cancelled. Date: Signature: CANDIDATE TO PLEASE NOTE: 1. Please note your IOCL registration no. for future reference 2. Please visit our website after about 3 weeks of declaration of GATE 2015 result for further information. 3. Please retain the photograph uploaded for GATE 2015 application. If you are shortlisted for further selection process. Same photograph may be required to be uploaded. 4. Mobile no. and email ID mention in this application form should remain valid for at least next one year. 5. If you are shortlisted for interview you will be required to produce this application form. 6. You may contact our helpline number 1860 354 0112 or write to us at [email protected] 1/1

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Indian Oil Corporation Limited(A Government Of India Undertaking)

Application form (Personal & Confidential)Please take the print out of the application form in A4 size portrait format only

GATE Reg. No. # : EC-77053S1089Indianoil Reg. No.# : 822588

Paste your recent selfattested Passport size

photograph and it shouldbe the same as

submitted along withGATE Application form

Date : 25-12-2014Post Applied : Officer/ EngineerCandidate's Name : Mr.VIKAS P SFather's / Husband's Name : POOMALAI PRelationship : FatherDate of Birth :13-08-1993Gender : MaleChoice for Interview Centre : ChennaiContact No : 9710938012 , 044-23643615Email Id : [email protected] Email Id : [email protected] You presently in Employment with IOCL : NoCategory : GenState of Origin / Domicile : TAMILNADUReligion : HinduWhether belong persons with Disabilities(PWD)? : NoWhether Ex-Serviceman : NoDomiciled in JK (between 01.01.1980 and31.12.1989) : NoMarital Status : UnmarriedDiscipline Applied For : Electronics & Communication EngineeringDiscipline Code : ECEducational Qualification DetailsName of Degree : B.E.Branch / Name of the Course : Electronics & Communication EngineeringCourse Duration : 4 Y - 0MWhether Full time Regular Course : Yeswhether Completed : NoIf Result Awaited expected to be announce in Monthof result : May -2015College / Institution Name : COLLEGE OF ENGINEERING GUINDY ANNA UNIVERSITYName of Affiliate University :Course Approved by AICTE : YesAddress for CorrespondenceAddress1 : JAINS AASHIANA G-11 PHASE-IAddress2 : NO 13 VEMBULIAMMAN KOIL STCity / Town : WEST KK NAGAR CHENNAIState : TAMILNADUPincode : 600078

Permanent Address if different from aboveAddress1 : JAINS AASHIANA G-11 PHASE-IAddress1 : NO 13 VEMBULIAMMAN KOIL STCity / Town : WEST KK NAGAR CHENNAIState : TAMILNADUPincode : 600078

Nearest Railway station : GUINDYAll the information given in this application form are true to the best of my knowledge and belief. If any of the information is found incorrect, my candidature may be cancelled.Date: Signature:CANDIDATE TO PLEASE NOTE: 1. Please note your IOCL registration no. for future reference2. Please visit our website after about 3 weeks of declaration of GATE 2015 result for further information.3. Please retain the photograph uploaded for GATE 2015 application. If you are shortlisted for further selection process. Same photograph may be required to be uploaded.4. Mobile no. and email ID mention in this application form should remain valid for at least next one year.5. If you are shortlisted for interview you will be required to produce this application form.6. You may contact our helpline number 1860 354 0112 or write to us at [email protected]

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