Nit Calicut
Nit Calicut
Department:
Project Name:
1. Name in Full: (in capital letter)
2. Father’s / Husband’s Name: (in capital letter)
3. Mother’s Name: (in capital letter)
(a) Date of Birth:
4.
(b) Age as on 23.06.2023
5. a) Marital Status: Married/Unmarried b) Gender: Male / Female
a) Permanent Address: b) Correspondence Address:
6.
S. No. Title of the Paper Author(s) Name of the Journal/ Vol. & Year/ Pages
Conference Venue
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”