Form : NITR/AC/202

National Institute of Technology

Rourkela
For Sponsored candidates only
(To be filled up by the employer sponsoring the candidate)
1. Name of the employer

: _______________________________________________________

2. Name, designation and

address of Administrative
Officer/HR manager

: _______________________________________________________
: _______________________________________________________
_______________________________________________________
Phone : __________________Fax:__________________________
Email : _________________________________________________

3. Name of the employee seeking

admission at NIT Rourkela
: ______________________________________________________
4. Designation (Regular)

: ______________________________________________________

5. (a) First joined on (date)

: ______________________________________________________

(b) Holding the present

position since (date)

: ______________________________________________________

(c) Nature of job

: ______________________________________________________
(R & D, Design, Production, Marketing, Administrative, Other )

(d) Brief description of job

: ______________________________________________________
assignment for the next
three years
______________________________________________________
(Relevant assignment only)
(e) Specific research/study area identified by the employer (if any):___________________________
6. The candidate is sponsored for : tick ( ) only one :
(i)

Two years full time study at NIT with deputation from the organization

(ii)

The candidate will be given enough time and flexibility in his/her job assignment in order
to continue his/her M.Tech programme as a local sponsored student under slow pace
category and will not be transferred to other places till the completion of the programme.

(iii)

One year full time study at NIT followed by project work at our organisation. The
candidates job assignment will be worked out in consultation with NIT.
Dr. ----------------------------------------------------------------------will serve as his/her second supervisor, if accepted
by NIT. A copy of his bio-data is enclosed.

Certified that Mr/Ms. ------------------------------------------------------------------------------------------------------------------------------------------------------- employed

as ----------------------------------------------------------------------------------------------------------- in this organization is sponsored for admission to
the M.Tech programme of NIT, Rourkela. He/she is employed in this organization for at least two years in
a regular cadre. During his/her studies at NIT, he/she will be on deputation from this organization to
satisfy the programme requirement. On completion of the programme he/she will continue to be
employed by our organization. He/she has signed an agreement with our organization for at least two
years on completion of the programme. A copy of the agreement shall be given to NIT Rourkela when he
is relieved from our organization for joining his studies. Further certifies that the candidate is being
sponsored by this organization at its own initiative because the organization recognizes that his
education and the consequent improvement of performance shall be of substantial value to this
organization.
Encl : As above
_____________________
Signature of applicant

_________________________________________
Signature of Competent Authority with seal
Date: