APPLICATION FOR EMPANELMENT OF DEVELOPERS FOR

INSTRUCTIONAL MATERIAL, QUESTION BANK, E-CONTENT, TECHNICAL

TRANSLATORS, TECHNICAL PROOF READERS & TECHNICAL EDITORS
1.

Name (in Block Letters)

2.
Date of Birth and Age
Address for communication

3.

a) Phone No. with STD Code

b) Mobile no
c) eMail id

5.

Educational Qualification
a) Academic
b) Technical

6.

No of years of experience
Details of Experience in Chronological
order

7.

.
( Please Attach Xerox copies of certificates pertaining to Qualification & Experience)
Sl
no

Name of the
Area/Sector/Trade

No of years of
experience in the
relevant
area/sector

No of translations
published

1
2
3
4
8. Any other relevant information :

DECLARATION
I ___________________________
hereby declare that the information furnished above are true to the
best of my knowledge and belief. . In case any of the data/information found to be incorrect the application is liable to
be rejected.
Place:
Date:

Signature

Note: The Executive Director, NIMI, reserves the right to reject the Application for Empanelment, without assigning
any reason