Aa Merged
Aa Merged
Aa Merged
Sr. Asst.
[Not Applicable to Technical Staff; Project must have a tenure of at least 18 months for Ph.D
and 12 months for M.Tech (R)]
2 9 0 5 1 9 8 4
9. Date of Birth :
d d m m
13. Academic career: (Enclose photo copies of the qualifying degree certificates and mark
sheets/grade cards showing the percentage of marks or CGPA from H.S.C onwards)
Name of Exams School/ Board/ Broad Subjects of Year of % of Marks/
College University Study passing CGPA
H.S.C CHINMAY B.S.E MATHS,SCIENCE,ODIA 1999 82.53%
VIDYALAYA ,ENGLISH,SOCIAL
STUDIES
H.S.S.C ISPAT VIDYA C.H.S.E +2 SCIENCE 2002 55.44%
MANDIR
Graduation S.G.WOMEN’S SAMBALPUR BSC 2005 50.91%
COLLEGE UNIVERSITY (MATH,BOTANY,ZOOL
OGY)
Post- Graduation DAMITS B.P.U.T MCA 2008 7.99 CGPA
16. Previous Research work and publication, if any: (Enclose copies of published or unpublished
work)
NOT APPLICABLE
17. Record of past study as a sponsored candidate, or other contractual obligation, if any:
NOT APPLICABLE
18. I do not have a close relative among officers and faculty of NIT Rourkela
I do hereby declare that the information furnished in this application is true to the best of my knowledge
and belief. If admitted, I shall abide by the rules and regulations of the Institute and Halls attached to it.
If any information furnished in this application is found to be untrue, I am liable to forfeit the seat allotted
to me any time in future and legal action be taken against me.
30/06/2020 jyotilakshmi behera
Date: Full signature of the Applicant
Enclosures: 1) MCA CERTIFICATE 2) GRADUATION CERTIFICATE