INDIAN INSTITUTE OF TECHNOLOGY PATNA

PROJECT CODE: R&D/SP/ME/MHRD&NDTL/DDA/2016-17/182

ADVT NO: R&D/182/MHRD/76

DATED:04.11.2016

FORMAT OF APPLICATION FOR PROJECT STAFF

Name & Address
Including email id and
Phone no.
(for Correspondence)
NAME IN CAPITAL
Address:

Category

DOB

(GEN/OBC/SC/ST/PD)

dd/ mm/yy

Professional Exam.
(GATE/CSIRNET, etc) &
Validity

Educational Qualification
Institute/ Board

Exam Passed

Year of Passing

% of Marks/CPI

10th Class
12th Class
B.Tech.
or equivalent

M.Tech.
or equivalent

Phone:
Email:

Qualifying degree
Degree/ major/Specialization
Professional/Industrial Name and Address of the
Experience
Industry/Organization
B.E/B.TECH.
M. Tech
Others

Experience relevant to project topic (within 50 words):