Application Form

Fields marked with * are mandatory

The candidates who have filled application form in response to Company’s Advertisement No.MD/EZ/CGM (HR&A)/HR/AO(D)2017/7828 dated 09.11.2017 need not to fill the application form again.

Company Name: Madhya Pradesh Poorv Kshetra Vidyut Vitaran Co. Ltd., Jabalpur,

Personal Details
Applicant's First Name*		Applicant's Middle Name		Applicant's Last Name
Father's First Name*		Father's Middle Name		Father's Last Name
Mother's First Name*		Mother's Middle Name		Mother's Last Name
Category:*		Nationality:*		Domicile of MP:*
Gender*		Marital Status:*			Are You an Ex Serviceman*
No. of Children		Last child birth date (In DD/MM/YYYY)		Is Your Last Child Born Twins
Date of Birth(dd/mm/yyyy)*	(In DD/MM/YYYY)		Age as on 01/01/2018	- -(yy-mm-dd)
Are You Physically Handicapped ?(Minimum percentage of disability shall be 40%)*				Type Of Physically Handicapped
ID Proof (Aadhar card/Driving License/Pan card/Voter id)*
NOTE :-The Post Reserved For SC/ST/OBC/PWD/Women Candidates Are Only For M.P. Domicile Candidate.

Educational Qualification
Have you completed your diploma*
Have you completed your graduation with minimum second division*

Qualification	Name of the Certificate/Diploma/Degree	Stream	Passing Year	University/Board	Institute/College Name	Obtained Percent (In 00.00 Format)
10th*	High School
12^th*	Higher Secondary
Diploma*
Degree*
CA pass or ICWA pass*		Year Of Passing*		CA/ICWA Roll No.*

* In case your University/Institute does not award marks, please convert grades(CGPA) to Percentage marks and fill.

*The candidate must have completed educational qualification as on last date of submission of application form.

* Write % of marks with two digits after the decimal. The second digit after the decimal should be rounded off. e.g., if Marks is 60%, then write 60.00%. If marks are 68.938% then write 68.94%.

Work Experience
Whether Employee of Govt./Corporation/Board/Autonomous Institutes and Home Guards*
* If yes, NOC from the organization will need to be produced at the time of Joining.
Are you working currently on the post of Accounts Officer (Contract) in any of the Companies mentioned at clause 2.15 of MPPKVVCL Contract Service (Agreement and Terms of Service) Revised Rules, 2018 : *

Communication Address
Address*
State*	City/Town*	Pin Code*
Email id*	Mobile No.*	Phone No.

Permanent Address(Same as Communication Address)
Address*
State*	City/Town*	Pin Code*
Mobile No.*	Phone No.

Bank Details
Account Number *		Bank Name *
Account Holder Name *		IFSC Code *

Instructions
Documents to be furnished in original at the time of verification of documents along with one set of photocopies attested by a Gazetted officer and a copy of online submitted application form / Receipt Certificate of Graduation Degree / Diploma. Each Semester / Year Mark sheet of Graduation Degree / Diploma. 10th Board exam Mark sheet as proof of date of birth. 12th Board exam Mark sheet. NOC from present Employer of Govt./Corporation/Board/Autonomous Institutes and Home Guards. Proof for availing benefit of age relaxation / reservation. Caste certificate for SC / ST / OBC category candidates. OBC category candidates will also have to produce non creamy layer certificate. MP Domicile certificate for SC / ST / OBC / UR category candidates. Copy of address proof of candidate. Copy of ID proof of candidate.

Attach Photo with Signature*


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I hereby declare that all the information given in the aforementioned application format is true to the best of my knowledge. I undertake and accept that if any of the information given by me is found to be Incorrect, then my application will be rejected and if appointed, then my Appointment will be terminated & action may be taken accordingly.