APPLICATION FORMPosition Applied H2S EngineerPersonal InformationName as in NRIC BENNY VARGHESEor PassportNRIC / Passport No. H7020264Nationality INDIANPlace of Birth KERALADate of Birth & Age 30/10/1987(dd/mm/yyyy)Marital Status SINGLENo. of Children & Ages NAAddress: KALLINGAL HOUSE,KAYARADI P.O,PALAKKAD, KERALA,INDIA-678510Home / Office Tel: 00919496352385 Mobile: 009199618961801Language Proficiency Spoken & Written ENGLISH , HINDI , MALAYALAM Spoken Only TAMILAcademic Qualifications (in chronological order, starting with the most recent) Date Schools/Institutions Attended Qualifications Obtained (Masters, Field of Study / Major From To Degree, Diploma, ‘A’/’O’ Levels)2005 2009 Mahatma Gandhi B.Tech Electronics & Instrumentation University EnginneringOther Qualifications / Courses / Membership Attained (in chronological order, starting with the most recent) Date Qualifications Obtained Date From To2009 2009july august • Undergone training on DCS ( Centum CS 3000 R3 Engineering and Maintenance) conducted by Yokogawa India Ltd. • Undergone training on PLC (Prosafe by Yokogawa) conducted by Yokogawa India Ltd. • Undergone training on Field bus technology conducted by Yokogawa India Ltd.
APPLICATION FORMEmployment History (in chronological order, starting with the most recent) Date Firm/Institution Position Held Reason(s) for Leaving From ToTotal number of years spent in oil/gas/petrochemical industry: 1.5 yearsDetails of Current EmploymentPresent Employer ConSyst Integrated Designation Application Engineer Control Systems, CochinStarted Date Notice Period 1 month (weeks / months)Present Monthly Salary 600 $ Expected Monthly Salary 1300 $Other InformationHave you been suffering from any physical impairment or disease? NoHave you ever been discharged or dismissed from the services of a previous employer? NoHave you ever been convicted in a Court of Law in any country ? NoIf the answer is “yes”, give details. ____________________________________________________________________________________________________________________________________________________________________________________________Referees
APPLICATION FORMPlease give details of two referees whom Rutledge E&P may approach for references.1. 2.Jasir SabriChief ExecutiveMob. +(91)-9387885015Email – firstname.lastname@example.orgConSyst Integrated Control SystemsCeeYem Building | Company Padi |Kerala | India |683 106 |DeclarationI declare that the information given above is, to the best of my belief, true and correct and that I have not suppressed any fact. Iunderstand that any misrepresentation or omission of any fact will be sufficient cause for the cancellation of consideration foremployment or dismissal from Rutledge E&P’s or its affiliate’s service if I have been employed.Signature of applicant: benny varghese Date: 09/02/2011