ITI LIMITED
(A Government of India Undertaking)
RAEBARELI PLANT, DOORBASH NAGAR,
SULTANPUR ROAD , RAEBARELI (UP)-229010
www.itiltd-india.com
1. Advt Ref. No & Date
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2. Post
3. SPECIALIZATION
4. NAME (IN CAPITALS)
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5. FATHER'S NAME
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6. GENDER
7. DATE OF BIRTH
[MM/DD/YYYY]
MM
/
DD
/
YYYY
8. AGE [AS ON DATE OF ADVERTISEMENT] ]
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9. INDICATE THE CATEGORY YOU BELONG TO
9(i) IF YOU BELONG TO SC/ST OR OBC STATE THE SUB CASTE
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10.PHYSICALLY DISABLED
10(i) IF YES, STATE THE NATURE AND % OF DISABILITY
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11. RELATIVES IF ANY IN ITI LIMITED
11(i) IF YES HIS/HER DETAILS , NAME, RELATIONSHIP, UNIT
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12. ADDRESS [MAILING]
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13. ADDRESS [PERMANENT]
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14. TELEPHONE NO. LAND LINE WITH STD CODE
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15. MOBILE NO
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16. EMAIL ADDRESS
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17. ACADEMIC QUALIFICATIONS
Less than 50%
50-55%
56-60%
61-65%
66-70%
71-75%
76-80%
Above 81%
SSLC
PUC
18. Engineering/Diploma [Indicate aggregate %, Incase of CGPA Convert the same to Percentage as per the conversion formulae applicable to your University/Institute]]
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18(a) WHETHER FULL TIME COURSE
Required
18(b). DURATION OF THE COURSE
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18(c) NAME OF THE INSTITUTION/UNIVERSITY
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18(d) Subjects
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18(e) MONTH & YEAR OF PASSING
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19. Additional Qualifications
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19(a) WHETHER FULL TIME COURSE
20 GATE SCORE
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20 (a) YEAR OF PASSING
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20 (b) PERCENTILE
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20 (c) ROLL NO
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21 POST QUALIFICATION EXPERIENCE IF ANY
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21(a) NAME & ADDRESS OF THE LAST EMPLOYER
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21(b) POST HELD
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21(c) PERIOD -[ FROM - TO ]
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21(d) JOB DESCRIPTION IN BRIEF
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21(e) PAY SCALE /SALARY DRAWN
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22. LANGUAGES KNOWN
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23. BRIEF SKETCH OF ACHIEVEMENTS NOT EXCEEDING 200 WORDS
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DECLARATION
NAME OF THE CANDIDATE
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Date of Application
MM
/
DD
/
YYYY
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