iaftdj.k la0 Regn No……………. ¼dk;kZy; iz;ksx ds fy,½ (for office use only) Hkkjrh; izkS|ksfxdh laLFkku] #M+dh #M+dh& 247 667 INDIAN INSTITUTE OF TECHNOLOGY ROORKEE ROORKEE-247 667
¼xSj 'kSf{kd o rdfudh inks ds fy, izkFkZuk i=) ¼APPLICATION FORM FOR NON ACADEMIC & TECHNICAL POSTS) ¼izR;k’kh }kjk Loa; Hkjk tk,/To be filled in candidate’s own handwriting )
I. II. III. IV. V.
uohure ikliksVZ lkbZt QksVks fpidk,sAa
vkosfnr in dk uke@ ………………………………………………………………… Name of the Post Applied for ………………………………...…………………....... foHkkx@dsUnz ………………………………………………………………………… Department/Centre………………………………………………………………..... foKkiu la0@....... …………………………..vk[kjh rkjh[k…………………………… Advt. No. …………………………………Closing Date………………………….. foKkiu esa in dk Øekad@............................................................................................. Sl. No. of the post in the Advt……………………………………………............. vkosnu 'kqYd dk fooj.k@....................................... (i) jkf’k #0@...................................
]
Affix latest passport size photograph
Particulars of Application Fee…………………… (i) Amount Rs. …………………….
(ii) cSd Mªk¶V ua0 …………….…….. fnukad@ …………… vnk fd;k-@-……………. Bank Draft No…………............... dated……………….. Payable at……………….
--------------------------------------------------------------------------------------------------------------------------1. iwjk uke ¼lkQ v{kjks esa ½ Name in full (IN BLOCK LETTERS)………………………………………… --------------------------------------------------------------------------------------------------------------------------irk ¼lkQ v{kjks esa½@ (I) i= O;ogkj ds fy,@For Communication (II) LFkkbZ@Permanent 2. Address (IN BLOCK LETTERS)
nwjHkk"k la0@
………………………………………
..........................................................
…………………………………… …………………………………… ….………………………………..
..................................................... …………………………………. ……………………….................
Tel. No. If any
--------------------------------------------------------------------------------------------------------------------------3. vk;q dk fooj.k@Particulars of (i) tUe frfFk@Date of Birth…………………… age (eSfVªD;wys’ku vFkok led{k (ii) vk;q ¼vkosnu izkfIr dh vfUre frfFk dks½@ izek.k&i= ds vuqlkj)/(as per Age (on last date of receipt of Application) Matriculation or equivalent o"kZ...................... ekg............................ Certificate)
Years….……….
Months.......................
(iii) tUe dk LFkku……………………………….. Place of Birth……………………………… (iv) jkT;……………………………………….. State ……………………………………… --------------------------------------------------------------------------------------------------------------------------4. firk@ifr dk uke@Father’s/Husband’s Name --------------------------------------------------------------------------------------------------------------------------5. (i) D;k vki vuqlwfpr tkfr@vuqlwfpr tutkfr@v0 fiNM+k oxZ@HkwriwoZ lSfud@’kkjhfjd #i ls gk¡@ugh fodykax oxZ ls lacaf/kr gS ? ¼;fn ^^gk¡** rks oxZ dk uke fy[ks vkSj ftyk eftLVªsV@ rglhynkj ;k lacaf/kr l{ke vf/kdkjh ls izkIr izek.k&i= lyaXu djsa½@Do you belong Yes/No to SC/ST/OBC/Ex. Service Man/PH category? ( If “ Yes” mention and attach certificate from District Magistrate/Tehsildar or the concerned Competent Authority) (ii) Do you belong to Uttaranchal state? (If Yes attach certificate) Yes/No
--------------------------------------------------------------------------------------------------------------------------6. D;k vki bl le; ljdkjh deZpkjh gS ? ¼;fn ^^gk¡** rks crk,a fd vkidh fu;qfDr vLFkk;h gk¡@ugh vFkok LFkk;h gS) vius fu;ksDrk dk iwjk irk fy[ksA /Are you a Govt. Servant at present? (If so, state whether your appointment is temporary or permanent) write full address of your employer.
Yes/No
7. D;k vki Hkk0 izkS0 la0 #M+dh ds deZpkjh gS? ;fn ^^gk¡** rks Li"V #i ls crkb, fd vkidh lsok,s fdl laLFkkiu ds vUrxZr 'kkfey gS ¼tSls fd laLFkkiu v/c/okbZ iwy@dqy’kkld laxBu@ [ksydwn la?k@ fuekZ.k [kaM+ vkfn ½Are you IIT Roorkee employee? If yes, clearly mention under
gk¡@ugh Yes/No
which establishment your services are governed (i.e. Estt.A/B/’Y’ Pool Staff/Deans Orgn./ Sports Assoc./Const. Division etc.)
deZpkjh dksM+ la0@Emp. Code No…………….. --------------------------------------------------------------------------------------------------------------------------8. ;ksX;rk ,oa vuqHko dk C;kSjk@PARTICULARS OF QUALIFICATION AND EXPERENCE (vuqyXu-I/Annexure-I) ;fn txg de gS rks vyx ls dkxt dk iz;ksx dj ldrs gSA vkosnd ;ksX;rk ,oa vuqHko ds leFkZu esa izek.k&i= ,oa 'kalki=ks dh vuqizekf.kr izfr;ka vo’; layXu gksuh pkfg,] ftuds u gksus ij vkosnu&i= vLohd`r gks ldrk gSA/(If space is insufficient, separate sheet can be used. Attested copies of certificate and testimonials in support of the qualifications and experience mentioned should invariably be attached, failing which application is liable for rejection) ----------------------------------------------------------------------------------------------------------------------------------------------------
9. vkosfnr in ls lacf/kr vU; dksbZ tkudkjh@Any other information relevant to the post applied for : eS ,rn~}kjk ?kks"k.kk djrk g¡@djrh gw¡ fd bl izi= es nh xbZ izfof"V;k¡ vkSj izLrqr fd;k x;k vU; fooj.k] ¼;fn dksbZ gks½ esjh loksZRre tkudkjh vkSj fo’okl ds vuqlkj lgh ,oa lR; gS vkSj bles dksbzZ ckr xqIr ugh j[kh xbZ gSA @I hereby declare that the entries in this form and additional particulars (if any) furnished in connection with the application are correct and true to the best of my knowledge & belief and nothing has been concealed therein.
LFkku@Place………………… fnukad@Date………………… izR;k’kh ds gLrk{kj@Signature of Candidate lyaXu@Encls :………………..(lwph layXu djsa@Enclose the list) --------------------------------------------------------------------------------------------------------------------------vxzs"k.k@FORWARDING igys ds fu;qDr deZpkfj;ksa dks vius vkosnu i= mfpr ek/;e }kjk Hkstus pkfg,A Hkk- izkS- la- #M+dh ds deZpkjh gksus dh fLFkfr esa izR;kf’k;ksa dks bls i`"Bkdu djkds vius vuqHkkxk/;{k@foHkkxk/;{k ls gLrk{kj djokdj Hkstuk pkfg,¼ftudh lsok,a laLFkkiu&v@c@ okbZ iwy@dqy’kkld laxBu@[ksydwn la?k@ fuekZ.k [kaM+ vkfn ½vuqHkkx }kjk 'kkfey ugh gS muds vkosnu i= ds izHkkjh }kjk ;FkkfLFkfr vxzsf"kr gksuk pkfg,A@Candidates already employed should get the application forwarded through proper channel. In case of IIT Roorkee employees, the candidate should get the following endorsement signed by his/her Section Head/Head of the Department [Whose services are not governed by Estt ‘A’/’B’ Section the application should be forwarded by In-charge, ’Y’ Pool Staff/Dean’s Orgn./Sports Assoc./Const. Division etc. as the case may be]
la0@No………………………......
gLrk{kj@Signature……………………
LFkku/Place………………………..
inuke@Designation…………………
fnukad@Date………………………
dk;kZy; dh eksgj@Office Stamp
vuqyXu-I Annexure-I (i) ;ksX;rk,a@QUALIFICATIONS 'kSf{kd@rduhdh@fo’ks"kKrk ds lkFk mrh.kZ dh xbZ O;kolkf;d ijh{kk,a@fo"k; ¼mPprj ls fuEurj½@
[email protected]
izkIr fd, x, vadks dk izfr’kr@
Grade/Divn.
% of marks/Grade obtained
mRrh.kZ djus dk o"kZ@ Year of passing
fo'ofo|ky;@cksMZ@ Name of the University/Board
Educational/Technical/Professional Exams. Passed with specialisation /subject (Higher to lower)
(ii) vuqHko@EXPERIENCE fu;ksDrk@laxBu dk uke ¼ekStqnk o iwoZ½ Name of employer/ Organisation (Present to previous)
inuke@
vkosnu&i= izkfIr dh vfUre rkjh[k dh vof/k@
Designation
Period on last date of receipt of application Rkkjh[k@DATES lsokdky@LENGTH ls From rd@To o"kZ@Year ekg@Months
dk;Z dk izdkj fo’ks"kKrk bR;knh dk {ks=@Nature of duties/ area of specialisation etc.
osru ,oa osrueku@ Pay & Pay Scale
dk;kZy; iz;ksx ds fy,@FOR OFFICE USE ONLY foKkiu% vkUrfjd@okg; @ADVERTISEMENT: INTERNAL/EXTERNAL 1. 2.
3. 4. 5. 6.
D;k izR;k’kh ,d vkUrfjd izR;k’kh gS] ;fn in vkUrfjd #i ls foKkfir gqvk gS \
gk¡@ugh
Is the candidate internal candidate, if the post has been advertised internally ?
YES/NO
D;k izR;k’kh vk;q&ekun.M dk ik= gS \ ¼ckg; izR;k’kh ds fy,½
gk¡@ugh
Is the candidate eligible from age criteria ? (For external candidates)
YES/NO
D;k izR;k’kh vkj{k.k fcUnq ls ijs gS \
gk¡@ugh
Is the candidature clear from point of view of reservation?
YES/NO
D;k izR;k’kh us fu/kkZfjr vkosnu 'kqYd ns fn;k gS \
gk¡@ugh
Has the candidate paid prescribed application fee ?
YES/NO
d;k izR;k’kh U;wure foKkfir ;ksX;rk izkIr gS \
gk¡@ugh
Does the candidate possess minimum advertised qualifications?
YES/NO
D;k izR;k’kh U;wure lacaf/kr vuqHko@fo’ks"krk {ks= izkIr gS\
gk¡@ugh
Is the candidate in the relavant area of specialisation and does
YES/NO
he/she possess the minimum experience?
7. 8.
10.
D;k izR;k’kh U;wure laf{kIr lwphdj.k ekun.M dks iwjk djrk gS\
gk¡@ugh
Does the candidate fulfill short-listing criteria?
YES/N0
ijh{kk o lk{kkRdkj ds fy, cqyk;k tk,@ugh cqyk;k tk,A
gk¡@ugh
To be called/not to be called for Test & Interview
YES/NO
dksbZ vU; vfHk;qfDr;ka Any other remarks (s)
laf{kIr lwphdj.k izkf/kdkjh ds gLrk{kj Signature of the short-listing Authority
izR;k’kh ds fy, vuqns’k 1-
/ INSTRUCTIONS TO THE CANDIDATES
izR;sd in ,ao Js.kh ds fy, i`Fkd vkosnu&i= izLrqr djsaA/Separate application should be submitted for each post and category
2-
vkosnu&i= ij vkosfnr in dk uke ,ao Js.kh Li"V mYys[k djsa vU;Fkk vkosnu&i= vLohd`r fd;k tk ldrk gSA/Name of the post and category applied for should clearly be indicated on the application form failing which the application is liable to rejection.
3-
Hkkjrh; izkS|ksfxdh laLFkku ds fu;eksa ds vuqlkj bu lHkh inks ads fy, os lHkh HkRrs ns; gksxsa tks lkekU;r% dsUnzh; ljdkjh deZpkfj;ksa ds fy, xzzkg; gSA/All the posts carry allowances as per the IIT Rules which at present are generally at par with those admissible to the Central Government employees.
4-
'kkjhfjd :i ls fodykax o HkwriwoZ lSfud izR;kf’k;ksa ds fy, vkj{k.k Hkkjr ljdkj ds fu;eksa ds vuqlkj gksxk/Reservation for Physically Handicapped & Ex-Servicemen candidates will applicable as per the Govt. of India rules.
5-
vkosnu&i= dh izkfIr dh vfUre frfFk ij xqzi ^lh* ds inksa gsrq vk;q 27 o"kZ o xzqi ^ch* ds inksa gsrq vk;q 32 o"kZ ls vf/kd ugha gksuh pkfg, tks fd Hkkjr ljdkj ds fu;eksa ds vuqlkj vuqlwfpr tkfr@vuqlwfpr tutkfr ds fy, vk;q esa 05 o"kZ o vU; fiNMh tkfr ds izR;kf’k;ksa ds fy, 03 o"kZ dh NwV gS A xzqi ^ch^ ,oa xzqi ^lh^ ds inksa gsrq ,sls vH;FkhZ tks dsUnz@jkT; ljdkj ds foHkkxkas] ljdkjh Lok;Ùkk izkIr laLFkkuksa tSls Hkkjrh; izkS|ksfxdh laLFkkuksa@fo’ofo|ky;ksa eas LFkkbZ inksa ij ljdkjh Lohd`r iS&LdSy esa dk;Zjr gSa dks mijksDr n’kkZ;h xbZ vk;w esa 5 o"kZ dh vfrfjDr lhek rd Ldzhfuax lfefr }kjk NwV iznku dh tk ldrh gSA 'kkjhfjd :i ls fodykax vkSj HkwriwoZ lSfudksa ds fy, vk;w esa NwV Hkkjr ljdkj ds fu;eksa ds vuqlkj gSA Age not more than 27 years for Group ‘C’ and 32 years for Group ‘B’ posts on last date of receipt of applications which is relaxable by 05 years for SC/ST candidates and 03 years for OBC candidates. Those applicants who are already working on regular posts in the Govt. approved scale of Pay in the State/Central Government organization, Government funded autonomous institutions like IITs/Universities may further be considered to grant 5 years age relaxation in upper age limit beyond prescribed age shown above for Group ‘B’ and ‘C’ posts. Relaxation in age limit to Physically Handicapped and Ex-servicemen will be admissible as per Govt. of India rules.
6-
izR;k’kh :i;s 4800@& xszM iS rd ds lHkh inks gsrq vius vkosnu&i= ds lkFk vkosnu 'kqYd :i;s 100@& dk cSad Mªk¶V dqylfpo] Hkkjrh; izkS|ksfxdh laLFkku :M+dh] :M+dh ds i{k esa] tks :M+dh ij ns; gks HkstsA Hkkjrh; izkS|ksfxdh laLFkku :M+dh] :M+dh ds deZpkfj;ksa rFkk vuqlwfpr tkfr@vuqlwfpr tutkfr ds izR;kf’k;ksa ls dksbZ 'kqYd vko’;d ugha gSA/Candidates should send a Bank Draft of Rs. 100/- in favour of Registrar, Indian Institute of Technology Roorkee, Roorkee payable at Roorkee alongwith application towards the Application Fee for all the post carrying Grade Pay upto Rs. 4800/-. No fee is required from IIT Roorkee, Roorkee employees and SC/ST candidates.
7-
p;u fyf[kr ijh{kk vkSj@;k iz;ksxkRed ,ao lk{kkRdkj ds vk/kkj ij gksxkA foKkfir inkas dk Hkjus] u Hkjus vFkok foKkiu dks iw.kZ :i ls ;k vkaf’kd :i ls fcuk dkj.k crk;s fujLr djus dk vf/kdkj laLFkku ds ikl lqjf{kr gS fyf[kr ijh{kk@lk{kkRdkj gsrq cqyk;s tkus okys vH;fFkZ;ksa dh ,d mfpr la[;k r; djus dk Hkh vf/kdkj laLFkku ds ikl lqjf{kr gSA foKkfir dh x;h 'kSf{kd ;ksX;rk U;wure gS] bu ;ksX;rkvksa dk j[kuk vH;fFkZ;ksa dks fyf[kr ijh{kk@lk{kkRdkj gsrq cqyk;k tkuk ugha gSA bl lEcU/k esa laLFkku dk fu.kZ; vfUrae gksxkA/Selection will be on the basis of written test and /or practical and interview. The Institute reserves the right to fill up the post, not to fill up the posts or cancel the advertisement in whole or partly without assigning any reason. The Institute will also reserve the right to place a reasonable limit on the total number of candidates to be called for written test/interview. Fulfillment of essential qualification pre-se does not entitle a candidate to be called for written test/interview. The decision of the Institute in this regard will be final.
8-
lsokfuo`fRr dh vk;q 60 o"kZ gSA/Retirement age is 60 years.
9-
igys ls fu;qDr izR;kf’k;ksa dks vius vkosnu&i= vius fu;ksDrk ds ek/;e ls fHktokus pkfg, ;k *vukifRr izek.k i=* layXu djuk pkfg, vU;Fkk vkosnu&i= vLohd`r dj fn;k tk;sxk/Candidates employed should route their application through their employer OR attach a NO OBJECTION CERTIFICATE with application, otherwise the application is liable to be rejected.
10-
lk{kkRdkj ds fy, cqyk;s x;s ckg; izR;kf’k;ksa dk U;wure ekxZ dk dk;ZLFky@fuokl LFkku ls :M+dh rd dk vkus tkus dk f}rh; Js.kh jsy fdjk;k fn;k tk;sxkA/Outstation candidates called for interview will be paid IInd class Railway Fare from the place of duty/residence to Roorkee and back by the shortest route.
11-
d`Ik;k vius nks orZeku@iwoZ fu;ksDrkvksa ds 'kalki= layXu djsaA/Please
enclose testimonials from two of your
present/previous employers. 12-
iw.kZ :i ls Hkjs x;s vkosnu&i=] cSad Mªk¶V ds lkFk vuqizekf.kr izek.k&i=ksa] 'kalki=ksa rFkk vukifRr izek.k&i=ksa dh izfr;k¡ ¼;fn mfpr ek/;e ls u Hkstk x;k gks rks½ lgk;d dqylfpo] laLFkkiu ¼c½] Hkkjrh; izkS|ksfxdh laLFkku :M+dh] :M+dh & 247 667 mRrjk[k.M dks Hksts rkfd vkosnu&i=ksa dh izkfIr dh vfUre frfFk ls iwoZ fey tk;sA vfUre frfFk ds i'pkr ;k iw.kZ lwpuk ds fcuk izkIr vkosnu i=ksa dks Lohdkj ugha fd;k tk;sxk/Completed application alongwith Bank Draft attested copies of certificate & testimonials and No Objection Certificates (if not routed through proper channel) should be sent to the Assistant Registrar, Establishment “B” Section, Indian Institute of Technology Roorkee, Roorkee - 247667, Uttarakhand so as to reach before the last date of receipt of application. Application received after last date or without complete information will not be entertained.
13-
ijh{kk@lk{kkRdkj@p;u ds lEcU/ka esa fdlh Hkh iwNrkN dk dksbZ mRrj ugha fn;k tk;sxk/No regarding test/interview/selection will be entertained.
interim queries
