National Institute of Technology, Uttarakhand

(Candidates are requested to download the format and fill in the information in his /her own handwriting in the space provided using blue ink only.)

I wish to apply for the Post of Superintendent / Accountant / Stenographer / Junior Assistant / Senior Assistant.
(Please tick the appropriate post)

Application Form
Name (Block Letters as mentioned
in HSSC Certificate)
Fathers / Husbands Name

Are you a Govt. /

Semi Govt./ PSU
Employee? (Y/N)

Address:

Self-Attested
Photograph

Contact Mobile
Contact
No.
E-mail Id
Age as on 12th
Date of Birth
____ Yrs _____ Months
April 2013
dd/mm/yyyy
Category: SC/ST
Person with Disability
/OBC/OPEN
Y/N
Examination (Tick
Year
Class % /
IIT/NIT/University
applicable degree)
CGP
HSSC (10+2)

Gender (Male /
Female)
Nationality
Experience
Total experience in Govt. organisation on
regular basis.
Total experience in Govt. organisation on
adhoc basis.
Other Experience

BE / BTech / BSc /
BA / BCom
MTech /ME/ MSc /
MA/MCom
PhD

Yes / No

MBA / LLB / CA

Do you have specialisation of Finance /

Accountancy at Bachelors/Masters Degree?
Do you have knowledge of word processing /
spread sheet?
Do you have knowledge of computer based
accounting software?

Other
Typing speed (more than 35 /
80 wpm)

Yrs.- Months

Knowledge of Shorthand
(Yes / No)

Details of Relevant Employment

Sr.
No.

Name of Employer

Designation

Nature
Work

of

Salary
AGP / Pay
Scale

From
Date

Till
Date

Length of Service
Yrs. - Months

References
Reference 1

Reference 2

Name
Designation
Organisation
Address
Phone No.
Email
Undertaking
I give the undertaking that I have read all the information and instructions given in Advertisement (Advt. No. 3/2013) on the
website www.nituk.com and the above information given by me is correct. I understand that my application shall be rejected if i)
the information is not correct or ii) all the required certificates and documents are not attached or iii) application is incomplete.
Date: ____ / ____ /2013
Place:_____________________
Candidate:___________________________
For Office Use Only
Inward No.: ______________Date: ___ / __ / 2013 Signature:
Registration No.:3/2013 ___________
Signature:
Data Entered by:_______Sign.:
Checked by:________ Sign.:

Signature of

Application No.
Final Remark
Signature

3/2013/

National Institute of Technology, Uttarakhand

(Candidates are requested to download the format and fill in the information in his /her own handwriting in the space provided using blue ink only.)

I wish to apply for the Post of Technical Asst. / Library & Info. Asst. / Students Activity and Sports Asst. / Laboratory Asst. /
Technician / Multitasking Staff in __________________________________________. (Please tick the appropriate post).

Application Form
Name (Block Letters as mentioned
in HSSC Certificate)
Fathers / Husbands Name

Are you a Govt. /

Semi Govt./ PSU
Employee? (Y/N)

Address:

Self-Attested
Photograph

Contact Mobile
Contact
No.
E-mail Id
Age as on 12th
Date of Birth
April 2013
dd/mm/yyyy
____ Yrs _____ Months
Category: SC/ST
Person with Disability
/OBC/OPEN
Y/N
Examination (Tick
Year
Class % /
IIT/NIT/University
applicable degree)
CGP
SSC (10)

Gender (Male /
Female)
Nationality
Experience
Total experience in Govt. organisation on
regular basis.
Total experience in Govt. organisation on
adhoc basis.
Other Experience

HSSC (10+2)
Diploma in Engg. /
ITI
BE / BTech / BSc /
BPEd / BLib
MTech /ME/ MSc /
MPEd / MCom

Yes/No
No. of events of students activity participated / organised &
representations of college in inter-university / inter-collegiate
tournaments (Give details on a separate sheet) (for SASA)

Do you have any PG Diploma in Computer

Application? (Yes / No)
Do you have knowledge of word processing /
spread sheet? (Yes / No)
Specialisation in
Post-Graduation

Other
Specialisation in
Diploma / ITI

Yrs.- Months

Specialisation in
Graduation

Details of Relevant Employment

Sr.
No.

Name of Employer

Designation

Nature
Work

of

Salary
AGP / Pay
Scale

From
Date

Till
Date

Length of Service
Yrs. - Months

References
Reference 1

Reference 2

Name
Designation
Organisation
Address
Phone No.
Email
Undertaking
I give the undertaking that I have read all the information and instructions given in Advertisement (Advt. No. 3/2013) on the
website www.nituk.com and the above information given by me is correct. I understand that my application shall be rejected if i)
the information is not correct or ii) all the required certificates and documents are not attached or iii) application is incomplete.
Date: ____ / ____ /2013

Place:_____________________ Signature of Candidate:___________________________

For Office Use Only

Inward No.: ______________Date: ___ / __ / 2013 Signature:
Registration No.:3/2013 ___________
Signature:
Data Entered by:_______Sign.:
Checked by:________ Sign.:

Application No.
Final Remark
Signature

3/2013/