Centre for Development of Advanced Computing

Gulmohar Cross Road No. 9, Juhu, Mumbai 400 049

Tel No. 022- 26703251, 26201606 26201488
Fax No. 022 -26210139, 26232195
Website : www.cdac.in

Affix one copy

of Passport size
photograph

Application Form
Each column should be filled. C-DAC may not consider this application, unless all columns have been filled.

Application for the Post of:

PROJECT ENGINEER - II

1. Name:
(Surname First)

2. Fathers/
Husbandsname:
3. Date of Birth

4. Sex

5. Nationality

7. Whether belongs to :
SC
8. Address for Correspondence with pincode:

Phone Nos. (with STD Codes)

ST

Name of the
Institute/ Board
University

PH

General

(Office)
(Residence)
(Mobile)

Fax
9. Academic Qualifications
Examination /
Degree

OBC

6. Marital Status

E-mail
Main Subject /
Specialization

Year of Passing

Percentage/
Grade/ Class

Rank /
Distinction,
if any

10. Work Experience (Latest First): (Please use additional sheets, if required)
Name of the
Organization

Designation

Grade & Total

Salary Drawn

Period of Service

From

Nature of Work

To

11. Are you employed in any Govt./Semi-Govt./Public Sector Undertaking/Govt. funded body?

Yes

No

If Yes, the application should be forwarded through proper channel or NOC to be produced at the time of interview.
12. Details of present employment:
i) Designation of the post held:
ii) Present salary drawn:
ii) Name of the organization with address:
13. Please furnish two references. References from relatives, friends, etc. should be avoided.
E-mail :

(1) Name:
Address:
Tel. No.: (Off.)

How does referee know you:

(Res.)

(2) Name:

E-mail :

Address:
Tel. No.: (Off.) :

(Mobile)

How does referee know you:

(Res.) : -

(Mobile) :

14. Please provide any other information that may have not been covered in this application form, to support your
Application.
(Use extra page if space is insufficient)
Declaration:
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. I understand that this application does not create a contract of
employment nor guarantee for employment. I have read and understood the above declaration before signing this.

Signature:
Place:

Date:

Note: Please do not attach any original Certificates. Copies of Certificates in support of Educational Qualifications, Age, current
employment and salary etc. should be attached. Testimonials in originals shall be required to be produced if called for interviews.