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Centre for Development of Advanced Computing (C-DAC) NIT Silchar Campus, Pin- 788010 Application for the Post of Technical Assistant ADVT: No: CDACS/GrpB-S&T/2016/003

PS: Each column should be filled. C-DAC may not consider this application, unless all columns have been filled. Please go through the General Terms and conditions as mentioned in the advertisement published in CDAC website. Application for the post of Technical Assistant 1. Name (in Block Letters): 2. Father’s name: 3. Date of Birth(dd/mm/yyyy) 4. Sex M 7. Whether belongs to :

SC

5. Nationality

6. Marital Status

F ST

OBC

PH *

General

8. Address for correspondence:

PIN CODE: Phone Nos.

(Mobile) (Office) (Residence) E-mail

9. Academic & Professional Qualifications (latest qualification first). Please use additional rows, if required. Name of Qualification

Name of the Institute/ Board/University

Main subject/ specialization

Year of passing

Percentage Class/Division/Rank/ of marks in Distinction, if any aggregate

10. Work Experience (Latest First): (please use additional rows, if required) Name of the organization

Designation & Grade

Total salary draw

Period of service From

To

Nature of work (mention specific experience which is relevant for this advertisement)

11. Please provide any other additional information (relevant to this post):

Declaration: 1. I certify that all information provided in this application is true, complete and correct to the best of my knowledge and belief. I understand that any false information or omission of information may disqualify me from consideration for employment and may result in dismissal from the job, if discovered at a later date. 2. I understand that this application does not create a contract of employment nor guarantee for employment. Signature:

Place:

Date:

Note: Please do not attach any original/copy of the Certificates. In case you belong to reservation category you need to attach a copy of the Caste Certificate in support of the claim. Certificates in originals shall be required to be produced if called for written test. *PH: Physically Challenged