(An Autonomous Institute of National Importance under DPIIT, Ministry of Commerce and Industry, Govt.

of India)

APPLICATION FORM FOR THE POST OF “ ------------------------------------------------------------.

(Notification no. NIDMP/1-70/(14) Rectt.- Admin/2025 dated 01.04.2025)

Appl. No.................................. (*To be filled by NID MP)

Note: Prospective candidates are advised to study the Instructions carefully and then fill up the
application precisely and to the point in all respects. Incomplete application will be summarily rejected.
Candidates may attach additional sheets, if required.

APPLICATION FORM FOR THE POST OF____________________________

(Tick the appropriate box) □ " On Deputation Affix recent passport size
photograph
OR
duly signed by the candidate
□ On Contract basis” across the photograph

Application Fee Details: (Exempted for Deputation case)

DD no. Date : Name of Bank:

1 Personal Information

Name of Applicant

(in full capitals)

Father’s Name

Mother’s Name

Date of Birth & Age

DD MM YY Years Months Days
(As on last date of receipt
of Application- proof of Age
dob to be enclosed)

Gender Marital Status

Nationality Religion
2
Category (SC/ST/OBC/General)

Ex-Serviceman (Tick) □ Yes □ No PwD (Tick) □ Yes □ No

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3. Complete Postal address with Pin code

Correspondence Address Permanent Address

PIN CODE PIN CODE

Other Contact information

Phone No with Mobile No.

STD Code

E-mail

Alternate E-mail

4. Educational Qualifications (10th Standard onwards) (Attach extra sheet, if needed)

[Link]. Name of Subject / Discipline / Name of the University / % of Division Year of

Degree/Diploma Specialization Institution / Board Mark/ /Grade passing
CGPA
1. 10th

2. 12th /Higher Sec

3. Diploma or
equivalent
4. Bachelor’s degree

5. Master’s degree

6. Desirable
qualifications (if any)

7. Others (if any)

5. Total Relevant Experience as on last date of Application :……...Years……....Months ...... Days.

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6 Details of Experience (In reverse Chronological order) (Attach extra sheet, if needed)

Organization / Designation Period Duration PB & G - Nature of Temporary/ Reason

Industry / Post Pay/Pay Responsi Regular/ of
From To Y M level bilities Permanent Leaving
Employment (if
applicabl
e)
a.

b.

c.

d.

e.

f.

7. Details of Present employment

Name of Organization / Institute

Date of
Designation
Appointment

Nature of Work
Whether
Temporary/ Regular Permanent
Employment

Pay Level

Basic Pay

Gross Emoluments (Per Month) in Rs.

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8. Character & Antecedents Report.

Particulars Comments

a. Have you ever been subject to any disciplinary action, as a student

and/or as an employee, If so give full details.

b. Have you ever been dismissed/suspended from

service/employment, if so please give full details

c. Were you ever involved in any criminal case, If yes, give full details

d. Is any criminal case pending against you in the court, If yes, give
full details

09. Language Known:

(i) Hindi : □Read □Write □Speak

(ii) English : □Read □Write □Speak
(iii) Other ( ) : □Read □Write □Speak

10. Details of Enclosures (Important: all the enclosures should be self-attested and serially numbered):

Sl. Description Page no.

no.

a. Application Form

b. Documents in support of Essential Educational Qualification

c. Documents in support of Essential Experience Qualification

d. Documents in support of other qualifications/ experience/ achievements

e. Documents in support of DoB

f. Category Certificate (EWS/OBC/SC/ST) (if applicable)

g. Ex-Servicemen Certificate (if applicable)

h. PwD Certificate (if applicable)

i. NOC from employer (if applicable)

j. Documents in support of all other qualifications

k. Certificate by the Employer/Cadre Controlling Authority with enclosures

(if applicable)

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 11. DECLARATION:

I hereby declare that I have carefully read and understood the instructions and particulars supplied to me,
and that all entries in this form, as well as, in attached sheets are true to the best of my knowledge and belief. I
undertake that If the fact that false information has been furnished or that there has been suppression of any
factual information in the Application Form comes to notice at any time during the service of a person her services
would be liable to be terminated.

Date:

Place:
Signature of the candidate

Certificate by the Employer/Cadre Controlling Authority

(for Deputation Case only)

The information/details provided in the above application by the applicant are true and
correct as per the facts available on records. He/she possesses educational qualifications and
experience mentioned in the vacancy Circular. If selected, he/she will be relieved
immediately or with in… days.

2. It is also certified that;

There is no Vigilance or disciplinary case pending/contemplated against Shri/Smt.
……………………………………………………..working as…………………..………………………………
(i) His/her integrity is certified.
(ii) His/Her APAR Dossier in original is enclosed/ photocopies of the ACRs for the last 5 years
duly attested by an officer of the rank of Under Secretary of the Govt. of India or above are
enclosed.
(iii) No major penalty has been imposed on him/her during the last 10 years Or A list of
major/minor penalties imposed on him/her during the last 10 years is enclosed (as the
case may be)

Countersigned
(Parent Employer/Cadre Controlling Authority with Seal

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