iaftdj.k la0 Regn No.

dk;kZy; iz;ksx ds fy, (for office use only)

Hkkjrh; izkS|ksfxdh laLFkku] #M+dh
#M+dh& 247 667
INDIAN INSTITUTE OF TECHNOLOGY ROORKEE
ROORKEE-247 667

xSj 'kSf{kd o rdfudh inks ds fy, izkFkZuk i=)

APPLICATION FORM FOR NON ACADEMIC & TECHNICAL POSTS)
izR;kkh }kjk Loa; Hkjk tk,/To be filled in candidates 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 ekad@.............................................................................................
Sl. No. of the post in the Advt.............
vkosnu 'kqYd dk fooj.k@....................................... (i) jkfk #0@...................................

Affix latest
passport size
photograph

Particulars of Application Fee (i) Amount Rs. .

(ii) cSd MkV ua0 ... fnukad@ vnk fd;k-@-.

Bank Draft No............... dated.. Payable at.

--------------------------------------------------------------------------------------------------------------------------1. iwjk uke lkQ v{kjks esa Name in full (IN BLOCK LETTERS)
--------------------------------------------------------------------------------------------------------------------------irk lkQ v{kjks esa @ (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 (eSfVD;wysku vFkok led{k
(ii) vk;q vkosnu izkfIr dh vfUre frfFk dks@
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@Fathers/Husbands 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 ? ;fn ^^gk** rks oxZ dk uke fy[ks vkSj ftyk eftLVsV@
rglhynkj ;k lacaf/kr l{ke vf/kdkjh ls izkIr izek.k&i= lyaXu djsa @ 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 ? ;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 tSls fd laLFkkiu v/c/okbZ iwy@dqykkld laxBu@
[ksydwn la?k@ fuekZ.k [kaM+ vkfn Are 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]
;fn dksbZ gks esjh loksRZ re tkudkjh vkSj fookl 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;kkh ds gLrk{kj@Signature of Candidate
lyaXu@Encls :..(lwph layXu djs@
a 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;kfk;ksa dks bls i`"Bkdu djkds vius vuqHkkxk/;{k@foHkkxk/;{k ls gLrk{kj djokdj Hkstuk pkfg,ftudh lsok,a
laLFkkiu&v@c@ okbZ iwy@dqykkld laxBu@[ksydwn la?k@ fuekZ.k [kaM+ vkfn vuqHkkx }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/Deans 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@foks"kKrk ds lkFk mrh.kZ dh xbZ
O;kolkf;d ijh{kk,a@fo"k; mPprj ls fuEurj@

xzsM+@Js.kh

izkIr fd, x, vadks dk izfrkr@

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 ekStqnk o iwoZ
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 foks"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;kkh ,d vkUrfjd izR;kkh 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;kkh vk;q&ekun.M dk ik= gS \

ckg; izR;kkh ds fy,

gk@ugh

Is the candidate eligible from age criteria ?

(For external candidates)

YES/NO

D;k izR;kkh vkj{k.k fcUnq ls ijs gS \

gk@ugh

Is the candidature clear from point of view of reservation?

YES/NO

D;k izR;kkh us fu/kkZfjr vkosnu 'kqYd ns fn;k gS \

gk@ugh

Has the candidate paid prescribed application fee ?

YES/NO

d;k izR;kkh U;wure foKkfir ;ksX;rk izkIr gS \

gk@ugh

Does the candidate possess minimum advertised qualifications?

YES/NO

D;k izR;kkh U;wure lacaf/kr vuqHko@foks"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;kkh 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;kkh ds fy, vuqnsk

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;kfk;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] vU; fiNMh tkfr ds izR;kfk;ksa ds fy, 03 o"kZ rFkk 'kk-fo- o- Hkw-iw-lS- ds fy, 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, 03 years for
OBC candidates and for Physically Handicapped/Ex-Servicemen as per Government of India rules.

6-

izR;kkh :i;s 4800@& xszM iS rd ds lHkh inks gsrq vius vkosnu&i= ds lkFk vkosnu 'kqYd :i;s 100@&
dk cSad MkV 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;kfk;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-

ljdkjh fu;ekuqlkj vuq-tkfr@vuq-tu-tkfr@vU; fiNMs oxZ@'kk-fo-@Hkw-iw-lS- ds izR;kfk;ksa ds fy, ekudks esa

NwB gksxhA/Relaxation of standards for SC/ST/OBC/Physically Handicapped/Ex-Servicemen candidates
exist as per Government Rules.

8-

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 vkafkd :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.

9-

lsokfuo`fRr dh vk;q 60 o"kZ gSA/Retirement age is 60 years.

10-

igys ls fu;qDr izR;kfk;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.

11-

lk{kkRdkj ds fy, cqyk;s x;s ckg; izR;kfk;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.

12-

d`Ik;k vius nks orZeku@iwoZ fu;ksDrkvksa ds 'kalki= layXu djsaA/Please enclose testimonials from two of your
present/previous employers.

13-

iw.kZ :i ls Hkjs x;s vkosnu&i=] cSad MkV ds lkFk vuqizekf.kr izek.k&i=ksa] 'kalki=ksa rFkk vukifRr izek.k&i=ksa
dh izfr;k ;fn mfpr ek/;e ls u Hkstk x;k gks rks lgk;d dqylfpo] laLFkkiu c] 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.

14-

ijh{kk@lk{kkRdkj@p;u ds lEcU/ka esa fdlh Hkh iwNrkN dk dksbZ mRrj ugha fn;k tk;sxk/No interim queries
regarding test/interview/selection will be entertained.