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APPLICATION PROFORMA (Ref: Advertisement No. WR-II HQ/Raipur/Lara/AT/2017) ntpc limited Western Region Headquarters II 4th Floor, Magneto Offizo, Magneto the Mall, Road, Labhandi, Raipur -492001 Fill all Details in CAPITAL LETTERS 1 Post Applied For: (Specify Only One) 2 Name: 3 Father s Name 4 Date of Birth* (DD/MM/YYYY) 5 Gender: 6 Nationality: 7 Category:* (UR/SC/ST/OBC-NCL) 8 Whether belong to PWD*: (Yes/ No) 9 Type of Disability:* (OA, OL, BL, HH) 10 Whether Belong to Ex Serviceman*: (Yes/ No) 11 No of Years in Service: (for Ex Serviceman) 12 Whether you are a Land-Oustee of ntpc -LARA (If Yes, Please specify Details) (i) Name of the Land Owner (ii) Relationship with the applicant Khata No. Survey No. Area of Land Acquired Name of Village from where land has been acquired 13 Detailed Postal Address: City/Town: District: State: PIN 14 Mobile Number: 15 Email: 16 Test Centre: (Raipur / Bilaspur / Raigarh) (Specify Only One) 17 Qualification* (Academic & Professional) Class X / XII / Graduation /ITI / NCTVT ) SL Examination/ Degree College /Board / University Year of Passing Class / Division Percentage in Mark

APPLICATION PROFORMA (Ref: Advertisement No. WR-II HQ/Raipur/Lara/AT/2017) NTPC Limited Western Region Headquarters – II 4th Floor, Magneto Offizo, Magneto the Mall, G.E. Road, Labhandi, Raipur -492001

  Limited, Ntpc limited, Ntpc

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