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NITR/RC/Application Form

SPONSORED RESEARCH, INDUSTRIAL CONSULTANCY


& CONTINUING EDUCATION CELL
NATIONAL INSTITUTE OF TECHNOLOGY ROURKELA
For Office use only
Serial Number of the Applicant: /

Sr. Asst.

Application for the Post of Project Officer/Research Associate/JRF/SRF/Technical Staff


(Application incomplete in any respect will summarily be rejected) Paste here your
recent passport size
1. Propose to enrol in a degree :  Non Student Ph.D.  colour Photograph
M.Tech(Res.)MCA

[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. Department /Centres to which applying for :

Department of Computer Science and Engineering

3. Name of the candidate in full :


JYOTILAKSHMI BEHERA
(Block Capital letters)

4. Project Title : SR/20/CS/001


5. Design and Development of E-learning Platform for Assisting
Underprivileged (SC/ST) School Students in Rourkela
Region, Odisha by Converging Cable TV Network and
Broadband Technology

6. Advt.No. with date :


7. NITR/SR/2020/Advt-CS001/L/001 dt. 22.05.2020

8. Address for Communication :

Tanaya Bhavan, Plot.No.- 696/1912, banposh, Pradhanpalli,

Infront of sai temple, chhend, kalinga vihar,

Rourkela-769015, Sundergarh, Odisha.

Tel. No. 9908132160 Email: jyotilaxmi.behera@gmail.com

2 9 0 5 1 9 8 4
9. Date of Birth :
d d m m

10. Sex : Female 9. Marital status : Married


NITR/RC/Application Form

10. Class of category :  SC  ST OBC General


NITR/RC/Application Form

11. Nationality : INDIAN 12. Mother Tongue : ODIA

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

Any other PGDCA SAMBALPUR COMPUTER SCIENCE 2004 NA


UNIVERSITY

14.  GATE /  NET Score: Subject: NA Score: NA Year: NA

15. Experience if any:


Organisation Position Duration Nature of job
KELLY SERVICES GIS OPERATOR 1 AND ½ YEARS SOFTWARE DESIGN

MINIVESTA SERVCES GIS ANALYST 1 YEAR AND 9 MONTHS SOFTWARE DESIGN

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 am related to ----------------of ---------------- Department

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

3) +2 CERTIFICATE 4) 10TH CERTIFICATE

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