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    Markel John
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    This document is an application form for non-teaching positions at the Indian Institute of Information Technology, Design and Manufacturing in Kancheepuram, India. The application requests information such as the applicant's name, date of birth, education history, work experience, references, and enclosures to support the application. It informs applicants to submit the hard copy of the completed application by post or in person to the specified address.

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    This document is an application form for non-teaching positions at the Indian Institute of Information Technology, Design and Manufacturing in Kancheepuram, India. The application requests information such as the applicant's name, date of birth, education history, work experience, references, and enclosures to support the application. It informs applicants to submit the hard copy of the completed application by post or in person to the specified address.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    24 views4 pages

    Application Form Non Teaching

    Uploaded by

    Markel John
    This document is an application form for non-teaching positions at the Indian Institute of Information Technology, Design and Manufacturing in Kancheepuram, India. The application requests information such as the applicant's name, date of birth, education history, work experience, references, and enclosures to support the application. It informs applicants to submit the hard copy of the completed application by post or in person to the specified address.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 4

    INDIANINSTITUTEOFINFORMATION TECHNOLOGY,DESIGNAND MANUFACTURING,KANCHEEPURAM

    kjRkh; LkwpUkk izkS|fxdh] vfdYiuk ,oa fofuekZ.k laLFkku] dkaphiqje

    Melakottaiyur,OffVandalurKelambakkamRoad,Chennai600048 Ph:+914427476300 Fax:+914427476301 Email:recruit@iiitdm.ac.in


    APPLICATIONFORNONTEACHINGPOSTS 1. PostApplied 2. AdvertisementNo 3. NameinFull(CapitalLetters) (asinSSLCCertificate) 4. DateofBirth (EnclosecopyofSSLCCertificate) 5. Nationality 6. Sex 7. (a)Category (b)Exserviceman(ES) (c)PersonwithDisability (Attachcertificate(s)) 8. AddressforCommunication : State: Pin: Phone: Mobile: Email: 9. PermanentHomeAddress : State: Pin: Phone: Mobile: Email: 10. NameofFather/Husband : : Age:_____Y_____M : : MALE/FEMALE : SC/ST/OBC/GEN(TickappropriateCategory) : YES/NO : YES/NO : : IIITDM/R/1/2012 : AffixPhotograph withlight background (5cmx4.5cm)

    11. DetailsofEducationStarringfromSSLConwards: Academic Qualification University/ Institute/Board Year& Month ofEntry Year& FullTime/Part Mark& Time/ Monthof Class Leaving Correspondence

    Discipline

    12. AdditionalQualification/Courses,ifany(Typewriting,Shorthand,ComputerCourse,Apprentice Programscompletedetc.,) Course Duration Certificate/ Organization WhetherGovt. approved Mark& Class

    13. ExperienceinChronologicalorderuptothepresent: Organization Designation From To ScaleofPay /TotalPay NatureofWork

    Organization

    Designation

    From

    To

    ScaleofPay /TotalPay

    NatureofWork

    14. DetailsofDemandDraft(Rs.100) attached:

    : No: IssuingBank:

    Date:

    (DrawninfavourofRegistrar,IIITDMKancheepurampayableatCHENNAI.) 15. (a)PresentEmployment (b)TimeRequiredtojoin,if offeredthepost (c)NatureofWork 16. Mentionwhydoyouliketojoin IIITDM? : : : : (Attachaonepagewriteup)

    17. Names,DesignationandAddresswithPhone,EmailIDofthreeReferees(withwhomyouhave interactionduringyourworkorstudyperiod) 18. Anyotherrelevantinformation(attachadditionalsheetsifnecessary): 19. I hereby declare that the information given above is true and correct to the best of my knowledgeandbeliefandIfullyunderstandthatifitisfoundatalaterdatethatanyinformation given in the application is incorrect / false or if I do not satisfy the eligibility criteria, my candidature/appointmentisliabletobecancelled/terminated. Place: Date: SignatureoftheApplicant

    20. EndorsementofthePresentEmployer: The application of Mr. / Ms. _______________________________________________ (Name and Designation of applicant) for the post of ____________________________, at IIITD&M KancheepuramisforwardedtotheRegistrar,IndianInstituteofInformationTechnology,Design andManufacturing(IIITD&M)Kancheepuram,Melakottaiyur,Chennai600048. Date:

    SignatureoftheHeadoftheOrganizationwithseal

    Enclosures: (i) AttestedcopiesofSSLC&HSC (ii) AttestedcopiesofDegree/Diploma/ITI/others (iii) Attestedcopiesofpreviousemploymentcertificate (iv) AttestedcopiesofSC/ST/OBC/PD/EScertificates (v) OnePagewriteupagainstitemNo.16. (vi) DemandDraftforRs100/ (vii) Anyotherinformation Totalno.ofsheetsexcludingmainapplication Submitthehardcopybypostorinpersonto: NumberofSheets attached ___ ___ ___ ___ ___ ___ ___ ___

    TheRegistrar IndianInstituteofInformationTechnologyDesign andManufacturing (IIITD&M)Kancheepuram Melakottaiyur Chennai600048

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