NATIONAL INSTITUTE OF TECHNOLOGY

Recent passport

KURUKSHETRA-136119

size color photograph APPLICATION FORM be affixed

Application for the post of .Advt. No.:.

1. Name of the Applicant:...........
   
   
2. Fathers/Husbands Name:........
   
   
3. Nationality:.
   
   
4. Date of Birth: ....
   
   
5. Category (SC/ST/OBC/GEN): ...
   
   
6. Gender (Male/Female): ..
   
   
7. Marital Status:...
   
   
8. Date of Retirement / Superannuation (if applicable):.....
   
   
9. Pension Payment Order No. & date, if applicable: .... (attach copy of PPO)
   
   
10. PAN Number (attach copy of PAN Card): ...
    
    
11. Aadhar No. (attach copy of Aadhar Card): ..
    
    
12. Last pay drawn/emoluments at the time of retirement (if applicable): ..
    
    
13. Post held at the time of retirement (if applicable): ..
    
    
14. Present Address: . . Pin Code: ...... E-mail ID: . Phone/Mobile No.: ..
    
    
    1. Particulars of Examination passed:
       
       
    2. -2
15. Details of Professional training obtained, if any, during the period of service:
    
    
16. Details of experience starting with the present post/retired from (separate sheet may be Attached, if required)
    
    
17. Any other information:
    
    

DECLARATION

It is certified that the information provided as above, is true & complete in all respect and to the best of my knowledge & belief. If anything is found wrong / incorrect, my application will be treated as cancelled and withdrawn.