BARODA DISTRICT CO-OPERATIVE

MILK PRODUCERS' UNION LTD.

APPLICATION FORM
To,
The Project Co-ordinator Please affix your
Mind Serve Consultancy Services Recent Passport
T-10/11, Vrund Complex, 3rd Floor, Size Photograph
Near Urmi Char Rasta, Akota, Baroda-390 0020.

1. Post applied for : __________________________________________________

PART A PART B
Psychometric Test & PI Written Test & PI
¨ Manager (Finance & Accounts) ¨ Jr. Officer (Marketing)
¨ Manager (Engineering) ¨ Jr. Engineer (Mechanical)
¨ Asst. Manager (Finance & Accounts) ¨ Jr. Engineer (Electrical)
¨ Asst. Manager (Purchase) ¨ Jr. Officer (Accounts)
¨ Asst. Manager (Quality Control) ¨ Jr. Officer (Administration)
¨ Asst. Manager ¨ Jr. Officer (System)
(For Chilling Center, Alhadpura, Bodeli) ¨ Milk Procurement Officer
¨ Superintendent (For Chilling Center, Alhadpura, Bodeli)
(For Chilling Center, Alhadpura, Bodeli) ¨ Security Officer
¨ Jr. Officer (Veterinary) ¨ Society Supervisor (For Baroda Dairy)
¨ Jr. Officer (Production) ¨ Society Supervisor
¨ Engineer (For Chilling Center, Alhadpura, Bodeli)
¨ Jr. Assistant
¨ Driver

2. Full Name (In Block Letters) : __________________________________________________

3. Communication Address : __________________________________________________

__________________________________________________

__________________________________________________

4. Contact No. : (R) _________________ (M) __________________________

5. Email ID : __________________________________________________

6. Permanent Address : __________________________________________________

__________________________________________________

__________________________________________________

7. Father's Name, Address & Profession, : __________________________________________________

if deceased his last profession __________________________________________________

and nationality of each parent __________________________________________________

8. Age ______________ Years, Height (C.M.) ______________ Weight (Kgs.) ___________

Date of Birth ____________________ Place of Birth ____________________

Nationality ______________________ Domicile ________________________

No. Age
9. Marital Status : ____________________
If Married number of Children & their Age Sons

Daughter
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10. Particular of S.S.C. Marks Total Marks
Examination Passed Year & Month
Obtained Subjects English Maths

11(a). Higher Education

Year of Class % of Marks

Sr. University College or Institute
Examination Passing obtain over total
No.
marks

11(b). Computer Knowledge :

12.(a) If you have taken any professional

Training give details with duration
of training & the names of the
successful completed courses :

(b) any other training :

13. Details of Membership of any

Professional / Academic Institute :

14 If you have published any articles /

papers give details :

15 Employment Record : The following record is very important for considering you for employment. List
your activities with dated intervals for your employment starting with your present
employment.

Particulars of Basic Pay & Other

Name & Place of Service From Reason for
Designation Duties & allowances showing
Previous Employers To Leaving
Functions scale of Pay

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16. Expected Total Salary :

17. Knowledge of Indian and Foreign Language :

Sr. Language Speak Read Write
No.
1 Gujarati

2 English

3 Hindi

18. Special Interest & Hobby :

19. If appointed when can you join?

20. Names, Contact No. and Address for references, of reputed persons these with whom you have come into contact
during.

1) Studies & Subsequent work : 1. 2.

2) Private Life 1. 2.

21. Did you suffer from any major Illness? If so give Particulars:

22. Any Physical Defects or Disability of permanent Nature of Chronic illness :

23. Marks of Identifications : 1. 2.

24. Are you prepared to work on Temporary Basis? :

25. If any your relatives working in this Union? Give names : Yes / No

26. Have you worked in this Union before?

27. Have you applied before ? : Yes / No

28. Were you called for Interview before ? If yes, give particulars.

29. Have you got your Name Registered If yes, State your Enrolment Number and Place of Employment Exchange:

30. Any other Information useful in relation to your application.

Declaration:
I hereby declare that all the above given / mentioned information is true & to the best of my knowledge. I agree that any information if found wrong or
unsatisfactory, then my application or appointment would stand disqualified. I agree that any issues / claims regarding this application / advertisement will
fall under Baroda jurisdiction only. I have read all the instructions given in Application form and advertisement given by Baroda Dist. Co-Operative Milk
Producers' Union Ltd. I agree & abide to the same.

Date Signature of Applicant

Name :
Address :

Please affix your

Recent Passport
Size Photograph

_____________________ _____________________
Applicant's Signature Authorised Signature

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 IMPORTANT NOTES
Please read instructions carefully before submitting the Application Form.
1) Please mention the Post applied for.
2) Application Fees Rs. 200/- for Part A and Rs. 100/- for Part B (each applied post) once
submitted is non-refundable in any circumstances.
3) If candidate is applying for more than one position, he/she will need to submit application
fee separately.
4) Application Fees (DD/Bankers' Cheque) has to be in favour of "Baroda District Co-
operative Milk Producers' Union Ltd." Payable at Baroda.
5) Write the name and address of the candidate behind the DD/Bankers' Cheque.
6) Application fees will be accepted thru DD/Bankers' Cheque only.
(Money Order, Cheque or any other mode of payment will not be accepted.
7) Mobile No., Email Address & Communication Address are mandatory.
8) Please recheck the application form & submit only if you are qualifying in the given criteria.
9) Complete application should reach at the below mentioned address on or before the last
date of submission mentioned in the advertisement. Application received after the last
date will not be accepted.
10) Passing criteria for written exam is 50%.
11) Mindserve and Baroda Dist. Co-Operative Milk Producers' Union Ltd. will not be
responsible for the applications lost in transit.
12) Part A - Psychometric Test and Personal Interivew.
l Only shortlisted candidates will be intimated for Psychometric Test and
Personal Interivew.
13) Part B - Written Test and Personal Interview.
l Intimation for Written Test Date, Time and Centre will be separately
communicated to shorlisted candidates only.
l Only candidates clearing the Written Exams will be intimated for Personal
Interview.
l Written Test will be of 100 marks, which will include Maths, General
Knowledge, logical reasoning, Aptitude Test and General English.

T-10/11, Vrund Complex, 3rd Floor, Near Urmi Char Rasta, Akota, Baroda-390020
Office Timing : 10.00am to 6.00pm (Sunday Closed)