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 Previous Research work and publication, if any: (Enclose copies of published or unpublished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
