CENTRE FOR DEVELOPMENT OF ADVANCED COMPUTING

(  
 , )
(A Premier R&D Organization of the Ministry of Electronics & Information Technology, Govt. of India)
(, *, / Vellayambalam, Thiruvananthapuram
:  -695 033/ Kerala : PIN 695 033
: 0471-2723333 / Phone: 0471-2723333

/APPLICATION FORM

(<)/05/2017 A 15.11.2017
1. 5 . /Advt. No.
CDAC (T)/05/2017 dtd 15.11.17
2. A /Post applied for

3. C / Category No.
M
4. /Name

5.  / Fathers Name /Affix your
6. /Sex (*/ E recent colour
Male/Female) passport size
photograph
7. F/ Nationality
(- H / )
(mention by Birth / Domicile)
8. A J: / Marital Status:
/ Yes < / No.
A / Married :

9. H (
) Date of Birth (As per SSLC
A/Day /Month M /Year
Certificate)
10. (29 17  J
) Age (as on 29 November 17)
M/Years /Months A/Days

11. M: / Religion

.. ... ... JN H
12. /Category SC ST OBC UR Others

13. <P Q  /
Whether physically handicapped. /Yes < / No

A <  / If yes give details   /   %/

Disability category % of disability
1.
14. S / Identification marks
2.

15. T / Blood Group

Contd ..2/-
 -:2:-

15. M
( ) /
Present Postal Address with Phone
Number & e- mail address
(for communication) / : ./
Phone : e-mail

16. /Permanent Address

/ : ./
Phone : e-mail

17. J J  M
Whom to contact in case of / : ./
Emergency. Phone : e-mail
18. / Q H Z JN/ \ ] ( ]  )
Recognized Educational/Professional Qualification commencing from SSLC / Xth onwards
(Enclose documentary proof)
<N / M /_ /Subject `M M/A a %
Examination/Degree Board/Univ. M Year Class/Div. /
of passing Marks(%) or
GPA

19. M (A ) : Details of work experience (if any):

/Period P P
Name of Organization Designation/Post / Gross Whether
/From /To & Place held Permanent/
Pay drawn
Temporary
(in Rs.)

Contd..03/-
 03.

20.    Pa , A
Particulars of close relatives, working in C-DAC, if any
P / / Division/Section  / Date of
Name of Relative & Relation /Position Joining

(   << / DD No.: e /Name of Bank

Details of processing fee <<  < / Date of DD:
remitted.
21. a  A Check list for the documents to be attached.

/Proof of age N /Education Experience.

M  / << / DD
/Proof of Caste Copies of Mark sheet

/
DECLARATION

e / A j T  e k  / A <
< < ma e / < A e  Q
A A A jM <  k < < /
e , < o< / T <  Z  / I understand that the
contractual appointment is purely temporary and I hereby declare that the information given above is
correct, true to facts and nothing has been concealed / distorted. I am aware that, if at any time I am
found to have concealed/distorted any material information, my candidature/engagement is liable to be
summarily terminated without notice.

</Date: ________________ (o N)/Signature of the Candidate)

/Place : _______________