LAST DATE OF SUBMISSION OF THIS FORM : 04/03/2010

?????? ???????????? ??????? ?????

INDIAN INSTITUTE OF TECHNOLOGY, BOMBAY

???? ?? 1 ?? ??? ????? /APPLICATION FOR TYPE H1


??????? ?????? : ?. ?./????/??????/2010/02/19                                                                                   ?????? ????????

CIRCULAR No. : EO/ACCOM/VACANCY/2010/02/19                                                               ESTATE OFFICE

                                                                                                                                       19/02/2010

 ???? ??? /To,

 ??????? ??????? ( ?????? ) / Superintending Engineer (Estate)

 ????, ?.?.??. - I ?? II / Secretary, AAC-I & II

  1. ???? ??? / Salary Code                                          :  ________________________________________________

  2. ??? / Name                                                         :  ________________________________________________

  3. ????? / Designation                                              :  ________________________________________________

  4. ?????/?????? / Department/Section                            :  ________________________________________________

  5. ?????? ??? ????? ???? ?? ???? / Date of Joining                  :  ________________________________________________

  6. ???? ?? ???????? ????/???????? ??????
    ???? ?? ????/ Do you belong to SC/ST category?              :  ???/YES ______________  /  ????/NO _______________
    (??? ???, ?? ????? ??????? ?????? ?? ??? ?? ???????
    ??? ?????? ???? ??????? ???? )/(IF YES, PLEASE OBTAIN              ???. ??. /SC _________  /  ???. ?. ????/ST ________
    CERTIFICATION FROM THE ADMIN. SECTION
    ON THE SPACE PROVIDEDIN THIS FORMAT)

  7. ???????? ???? ?? ??? ????? / Type of Quarter Applied for  :  ____________________H1________________________

    8. ????? ???? ????? ?? ?????? ???? ???? ?? ????????, ???? ??? ????
    Please indicate your preference below according to your choice.

    • _______________

    • _______________

    • _______________



  8. ??????? ???????? ?????? / Present Quarter No.                    :  ________________________________________________

  9. ????????? / Signature                                               : ________________________________________________

  10. ?????? / Date                                                       : ________________________________________________

________________________________________________________________________________________________________________________

????????? ?? ?????? ?? / VACANCIES AS FOLLOWS :

???????? ?????? / QUARTER NO. : H1-100

?????????? / CERTIFICATION


???????? ???? ?? ??? ?? ?? ??????? ?? ??????? ?? ??????, ????????? ????? ???????? ???? / ???????? ?????? ?? ???

Certified that according to the records of the Institute, the above applicant belongs to SC/ST.





?????? / DATE  :                                                                                                                ??????? / REGISTRAR

Legacy of Egypt