ANNEXURE
NATIONAL INSTITUTE OF TECHNOLOGY
CALICUT
NITC CAMPUS (PO), KOZHIKODE, KERALA-673601
(Application Form for Field Assistant)
●
Post Applied: Name of the Post Salary
Field Assistant
Department: CIVIL ENGINEERING
Project Name: Monitoring mechanical behaviour of rock concert joint using Electro-
Mechanical Impedance Technique
1. Name in Full: (in capital letter) ANUMULA VINAY KUMAR
2. Father’s / Husband’s Name: (in capital letter) VEERABHADRACHARY
3. Mother’s Name: (in capital letter) PADMAVATHI
(a) Date of Birth: 11/06/2000
4.
(b) Age as on 07.06.2024 24
5. a) Marital Status: Unmarried b) Gender: Male
b) Correspondence Address:
a) Permanent Address:
8-21,
Beside Sai balaji
theater, 8-21,
Nelakondapally, Beside Sai balaji
Khammam district, theater,
telangana, 507160 Nelakondapally,
6. Khammam district,
telangana, 507160
Phone: (with STD code)
E-mail:
[email protected] Mobile No. 9533051381
7. Nationality: INDIAN
Note: Attach proof of date of birth and photo ID
8. Details of Educational Qualifications
(a) From SSLC/Matriculation up to the highest degree (Attach Scanned copies of
Relevant Certificates & Mark Lists)
Exam Board/ Year of Class/ Percent of
Specialization College/ Institute
Passed University Passing Grade Marks/CGPA
School of secondary
SSC VIKASA SCHOOL education
2015 9.0
telangana
GOWTHAMI Board of intermediate
INTERMEDIATE MPC education telangana 2017 95.5 %
JUNIOR COLLEGE
CIVIL KAKATIYA KAKATIYA
B TECH 2021 69 %
ENGINEERING UNIVERSITY UNIVERSITY
(b) Attach GATE/NET certificate, if applicable
GATE Score
NET date of qualification
9. Details of the Major Project/Thesis done as a part of the course (Title, Abstract,
outcome and contributions shall be included as an attachment.)
10. Details of employments / experience:(Attach Proof)
Name and
S. Pay-Scale Type of
Address of Designation From To Duration
No. & AGP/GP Organizatio
Employer
n
11. Research Publications (if any):
(a) Papers published in National / International Journals/Conferences: (Attach copyof First
Page of Paper):
S. No. Title of the Paper Author(s) Name of the Journal/ Vol. & Year/ Pages
Conference Venue
12. Awards / Distinctions won: (Attach Proof)
13. Any other Relevant Information:(Attach separate sheet if required)
DECLARATION
“I hereby declare that the entries in this form are true to the best of my knowledge and belief.
I understand that my candidature will be cancelled if any of the information is found to be false
or incorrect. Further, if selected, I will abide by the rules and regulations of the institute and
also the directions given to me from time to time”
Place: nelakondapally Signature of the
Applicant Date: 30-06-2024
Name: ANUMULA VINAY KUMAR
NO-OBJECTION CERTIFICATE TO BE FURNISHED BY THE CANDIDATE WHO IS ALREADY IN
EMPLOYMENT ON REGULAR/TEMPORARY BASIS.
