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Technology Information Forecasting and Assessment Council (TIFAC) Autonomous body under Department of Science & Technology Government

of India (Reference No. TIFAC/Adv/Rec/.) Application for Project Associate

1. 2. 3. 4. 5.

Name of the Applicant Fathers/Husbands Name Date of Birth Nationality Permanent Address

: : : : :

6. Address for communication :

7. E-mail, Phone, Mobile : 8. Educational Qualifications : Name of the Degree Disciple/ Specialization Name of University/ Institution Year of passing Main subjects taken % of Marks/ CGPA

9. Details of Other Examinations Passed/Trainings undergone: Name of Exam/ training undergone Examination passed Name of Institution Duration Remarks

10. Details of Experience in chronological order: Name of Post held, Organization with date Nature of duties (Pl. attach separate sheet if required) Total emolument drawn etc

-211. References (Two references with their addresses and phone nos/ e- mail ID) 12. Please provide a statement in support of your suitability for Project Associate (Max. 150 words)

Declaration

I do hereby declare that the information furnished above is true and complete to the best of my knowledge and belief.

Date: Place: Signature

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