Indian Institute of Technology Roorkee Generated On: 2023-08-29 18:02:31

ONLINE APPLICATION FORM

Application No. Post Organizational Unit Advertisement No.

CRRN15349 Coach (Table Tennis) Administration Section IITR/Rect Cell/2023/1

Application Fee Details

Order ID Transaction ID Mode of Payment Amount Date
4989 230812160899876 Online Mode 400.00 2023-08-12 13:31:19

Candidate Details
Candidate’s Name THAMIZHANBAN G
Email ID anbanthamizh39@gmail.com
Father's Name GOWRAVAN
Mother's Name SUJATHA
Date of Birth 10-12-1989
Age (as on 2023-08-13) 33 years, 08 months, 03 days
Gender Male
Category OBC
Marital Status Married
Nationality Indian
Whether a person with disability Not Applicable
PAN/Passport/DL/Voter ID AYLPT9785C
Phone No
Mobile No 9952652599
Religion Hindu
Ex Serviceman No
Employee of IIT/CFTI No
Are you an employee of Govt of India who
have rendered not less than 3 years
No
regular and continuous service as on
closing date for receipt of application
Address for Correspondence Permanent Address
109/1, FD BLOCK, SECTOR 3, 44, JEEVARATHINAM STREET,
SALT LAKE CITY VEERAMPATTINAM
PUDUCHERRY ,Puducherry PUDUCHERRY ,Puducherry
605007 ,India 605007 ,India

Present Employment Details

Name of the Post ASSISTANT TABLE TENNIS COACH
Type of appointment Contractual
Date of Appointment 2019-12-02
Employer's Name SPORTS AUTHORITY OF INDIA
Pay Band and Grade Pay(6th CPC)/Equivalent 2000
Pay Level/Equivalent Level - 3
Gross Emoluments Rs.50300
Age of retirement in the Present Post 64.00
Date of retirement in the Present Post 2024-01-01
Whether you are receiving any pension No

Page 1 of 4 ©Samarth eGov

Indian Institute of Technology Roorkee Generated On: 2023-08-29 18:02:31

Educational Qualification
Schooling Details
Year of Grade/Mar Percentage
Examination Main Subject School/College Board/University
Passing ks /Grade
10th/SSC/Ma ENGLISH, MATHS, SCIENCE
2005 Percentage 65.8 SCSV GOVT SCHOOL TAMILNADU STATE BOARD
tric & SOCIAL SCIENCE
ENGLISH, ECONOMICS,
JEEVARATHINAM Hr.
12th/Diplom COMMERCE,
2007 Percentage 67.3 SECONDARY SCHOOL, TAMILNADU STATE BOARD
a ACCOUNTANCY &
PUDUCHERRY
BUSINESS MATHS

Graduation Details
# Degree Name Main Subject Grade/M Percentage/Gr Year University/Institu State/Union Country
arks ade tion Territory

1 BACHULOR OF SCIENCE COMPUTER SCIENCE Percenta 59.2 2012 PONDICHERRY PUDUCHERR INDIA
(COMPUTER SCIENCE) ge UNIVERSITY Y

Post-Graduation Details
# Degree Name Main Subject Grade/M Percentage/Gr Year University/Instit State/Union Country
arks ade ution Territory

1 MASTER OF BUSINESS HUMAN RESOURCE Percenta 65.09 2017 PONDICHERRY PUDUCHERR INDIA
ADMINISTRATION MANAGEMENT ge UNIVERSITY Y

M.Phil. Details
# Degree Name Main Subject Grade/Marks Percentage/Grade Year University/Institution State Country

Ph.D. Details
# Status Date Thesis Title University/Institution

Other Qualifications
# Title Date Description University/Institution

1 International Coaching 2009-04-25 Completed International Coaching Course LEVEL - 2 in International Table Tennis
Course LEVEL - 2 in the game of Table Tennis Federation (ITTF)
Table Tennis game

2 International Coaching 2018-04-29 Completed International Coaching course LEVEL - 1 in International Table Tennis
Certificate - LEVEL - 1 the game of Table Tennis Federation

3 DIPLOMA IN SPORTS 2014-06-30 Completed sports coaching in Table Tennis game at NETAJI SUBHAS NATIONAL
COACHING (TABLE Netaji Subhas National Institute of Sports - Patiala. INSTITUTE OF SPORTS - PATIALA
TENNIS) AT NSNIS

4 DIPLOMA IN TEACHER 2009-06-01 Diploma completed in Teacher education Tamilnadu State Board
EDUCATION

Relevant Work Experience

# Type Name of Organization Designation Pay Band and Pay Level(as Type From To Experience
Grade per 7th of
Pay(6th CPC)/Equivale empl
CPC)/Equivale nt oyme
nt nt

1 Teaching GANDHIJI HIGH SCHOOL - TABLE TENNIS Rs.8000 Level-3 Contr 08-02-2006 17-11-2013 07 years, 09
PUDUCHERRY COACH act months, 09
days

Page 2 of 4 ©Samarth eGov

Indian Institute of Technology Roorkee Generated On: 2023-08-29 18:02:31

# Type Name of Organization Designation Pay Band and Pay Level(as Type From To Experience
Grade per 7th of
Pay(6th CPC)/Equivale empl
CPC)/Equivale nt oyme
nt nt

2 Teaching TENVIC SPORTS EDUCATION TABLE TENNIS Rs. 20,000 Level-3 Contr 06-07-2015 22-02-2016 00 years, 07
(P) LTD COACH act months, 16
days

3 Teaching Pondicherry State Sports Table Tennis Coach Rs.10,000 Level - 3 Contr 23-02-2016 30-11-2019 03 years, 09
Council act months, 07
days

Research Papers / Review Articles / Conference Proceedings (In Related Areas Only)

# Publication Type Title of the Paper Journal ISSN/ ISBN No. Refereed Author Year
Name/Page
Numbers

Research Publications - Books,Chapters, Edited work, Articles etc. (In Related Areas Only)

# Publication Type Title ISSN/ ISBN No. Refereed Author/Co-Author Publisher (city/country) Year

Research Projects

# Title Major/Minor Period Total Name of Outcome of the

(Months) Grant/Funding Sponsoring/ Project
received(Rs.) Funding Agency

Miscellaneous Information
Time required for joining (in days) ? 10
Do you have Computer Proficiency
Yes
Certificate?
As an Academic Coach In-Charge in the discipline of Table Tennis at Sports Authority of
India, I produced more than 300 Professional & Efficient Table Tennis Coaches to this
Kindly describe your contribution to
Country in the name of different Courses like Diploma in Sports Coaching, Six Week
institutions where you have worked
Certificate Course & Refresher Course. As a Table Tennis Coach I maintained International
(in about 500 words)
standards on Coaching in the game of Table Tennis. I worked hard and dynamically for the
SAI organization and also received many home awards from the Organizational head.
I have international standard coaching skills in the game of Table Tennis so, I will work hard
What makes you suitable for the post for this organization and I'm sure I will produce many national & International players in the
you have applied? (500 words max.) name of IIT Rookee. I will give my full support to this organization to develop the game of
Table Tennis towards international standards.
Honours and awards (if any) NA

Have you been debarred or punished for adopting

unfair means in any Examination by the No Description: NA
Institution/Board/University?
Have you ever been involved in any administrative
No Description: NA
malpractice?
Have you ever been involved in any financial
No Description: NA
irregularity?
Were you ever discharged or dismissed from any
No Description: NA
previous employment?
Is there any pending or contemplated disciplinary
No Description: NA
proceedings against you?

Two Referees familiar with your profile and professional contribution

Page 3 of 4 ©Samarth eGov

Indian Institute of Technology Roorkee Generated On: 2023-08-29 18:02:31

S Institutional Mobile /
No. Full Name Affiliation Designation Address Phone No. Email

1 MR. VINEETH SAI, Netaji Subhas SAI, Executive SAI, NSE, 9888713704 saieastacademics@gmail.com
KUMAR Eastern Centre- Director Salt Lake
Kolkata City, Kolkata

2 MR. SAI, Netaji Subhas ACADEMIC SAI, NSE, 9163855882 saieastacademics@gmail.com

GUNADHAR Eastern Centre- INCHARGE Salt Lake
MONDAL Kolkata City, Kolkata

5.2 Languages Known

# Language Known Speak Read write

No Objection Certificate
Forwarded with the remarks that the facts stated in the above application have been verified and found correct and this Institution/
Organization has no objection to the candidature of the applicant being considered for the post applied for.
SAI, NETAJI SUBHAS
NOC Issuing SPORTS AUTHORITY OF TABLE TENNIS
Designation Place EASTERN CENTRE -
Authority INDIA COACH
KOLKATA
SPORTS AUTHORITY OF INDIA, NETAJI SUBHAS EASTERN CENTRE,
Date of Issuance 21-02-2023 Address
SALT LAKE CITY, KOLKATA-700098

Declaration

I declare that the statements made in this Application Form are correct and true and also complete to the best of my knowledge
and belief. I am aware that if at any stage it is found that the statements made are not true or are incomplete/misleading, my
candidature is liable to be cancelled

Date: 2023-08-12 13:31:19

Page 4 of 4 ©Samarth eGov