NETAJI SUBHAS UNIVERSITY OF TECHNOLOGY, EAST CAMPUS

(Ambedkar Institute of Advanced Communication Technologies & Research)

Geeta Colony, Delhi-31
(Office of Students Welfare Officer)

APPLICATION FORM

Application for (Mention name of the post & corresponding society/ team)

(i).........................................................................................................................

(ii).........................................................................................................................

(iii).......................................................................................................................

(iv).......................................................................................................................

(v).........................................................................................................................

1. Name: ……………………………………………………………………..................................

2. Guardian’s Name……………………………………………………………...............................

3. Roll No:...............................................4. Class/ Section:.....................................................

5. Gender: ⬜ Male ⬜ Female 6. Date of Birth (dd/mm/yyyy):................................

7. Contact No:................................8.Email…………………………..............................

9. Relevant Past Experience, if any (Proof Attached)……………………….........…

……………………………………….................................................................................

.......................................................................................................................................

......................................................................................................................................

I certify that the information contained within this application, along with all the information
attached to this application is true.

Candidate’s Signature with date