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Application for Employment Notice No.BMRCL/ADM/O&M/01/2010 dt. 13.02.2010
* Mandatory Fields; ** Either one of them is Mandatory field
01.
Select Category of Post *
:
Select Category-01 Category-02 Category-03 Category-04 Category-05 Category-06 Category-07 Category-08 Category-09 Category-10 Category-11 Category-12 Category-13 Category-14
02.
Candidate's Full Name *
:
03.
Father /Guardian's Name *
:
04.
Mother's Name *
:
05.
Nationality *
:
Indian
Others
06.
Religion *
:
Hindu
Muslim
Christian
Sikh
Budhist
Jain
Parsi
Others if OTHERS specify
07.
Gender *
:
Male
Female
08.
Marital Status *
:
Married
UnMarried
09.
Date of Birth *
:
Day Select Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Select Month 01 02 03 04 05 06 07 08 09 10 11 12 Year Select Year 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 Age :21
10.
Category *
:
GM
SC
ST
OBC
11.
Visible Mark of Identification on Body
:
12.
Full Address for Communication *
:
mathapati galli sant saina
road near allvi mazid bijapur*
State *
:
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
District *
:
Select Bagalkot Bangalore Rural Bangalore Urban Belgaum Bellary Bidar Bijapur Chamarajnagar Chikballapur Chikmagalur Chitradurga Dakshina Kannada Davanagere Dharwad Gadag Gulbarga Hassan Haveri Kodagu Kolar Koppal Mandya Mysore Raichur Ramanagara Shimoga Tumkur Udupi Uttara Kannada
Pincode *
13.
Place of permanentresidence *
:
mathapati galli sant saina
road near allvi mazid bijapur
14.
Priority wise Preference of Examination Centres *(Enter number from 1to 4; where 1is the highest Priority)
:
Center Name
Enter Priority Number
Bangalore
Mysore
Belgaum
Gulbarga
15.
E Mail *
:
Reconfirm E Mail *
:
16.
Landline Number **
:
17.
Mobile Number **
:
18.
Knowledge of Kannada *
:
Speak
Read
Write
Understand
19.
Essential Qualification Prescribed *
Group
Qualification
Specify
Board/University/Institute
State
Year of Passing
Percentage of Marks
1
Matriculation
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
2
Three Years Engineering Diploma in Electrical Engineering
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
2
Three Years Engineering Diploma in Mechatronics.
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
2
Three Years Engineering Diploma in Mechanical Engineering
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
2
Three Years Engineering Diploma in Industrial Electronics
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
2
Three Years Engineering Diploma in Electronics & Communication Engineering
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
2
Three Years Engineering Diploma in Electrical power Systems
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
2
Three Years Engineering Diploma in Electrical & Electronic Engineering
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
2
Equivalent Three Years Engineering Diploma in any of the above Discipline
Select Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Puducherry Punjab (India) Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Daman
20.
Experience
SlNo.
Organisation Name
Nature of Work
Experience in Months
1
2
3
4
5
I have read the instructions carefully and hereby undertake to abide by them. I further declare that, I fulfill all the eligibility conditions such as age, educational qualification etc., as prescribed for the post. I hereby declare that all contents filled in this application are true, complete and correct to the best of my knowledge and belief. I have read the rules and understand that in the event of any information being found false or ineligibility being detected before or after the selection ,action can be taken against me by BMRCL, as it deems fit.
21.
22.
Saved
23.
Application Number
:
System generated unique No. Please Notedown this Number
24.
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