JSS MAHAVIDYAPEETHA
JSS ACADEMY OF TECHNICAL EDUCATION, NOIDA
Approved by All India Council for Technical Education (AICTE), New Delhi.
UG programs are Accredited by National Board of Accreditation (NBA), New Delhi.
Affiliated to Dr APJ Abdul Kalam Technical University, Uttar Pradesh, Lucknow.
www.jssaten.ac.in
Department of Computer Science and Engineering
APPLICATION FORM
Research Project Entitled: "IoT-Based Peer-Peer Energy Trading System
Using Ethereum Blockchain and Microcontrollers."
File no.: CST/D-1395 dated: 20.10.2023
Project id: 3110
Funding Agency: Council of Science & Technology UP, Department of Science &
Technology, Govt. of Uttar Pradesh
Name of P.I./Co-P.I. : Dr. Nitima Malsa/Dr. Rachna Jain/Dr. Sur Singh Rawat/
Mr. Vimal Gupta
Name of position: Research Assistant (on contract)
Department: Computer Science and Engineering
1. Name of the Candidate (In Capital):
2. Sex (Male/Female):
3. Marital Status (Married/Unmarried):
4. Date of Birth:
5. Age (as on 01/04/2023):
6. Father’s/Husband’s Name:
7. Present/Contact Address:
8. Permanent Address:
Years
Months
Days
JSS MAHAVIDYAPEETHA
JSS ACADEMY OF TECHNICAL EDUCATION, NOIDA
Approved by All India Council for Technical Education (AICTE), New Delhi.
UG programs are Accredited by National Board of Accreditation (NBA), New Delhi.
Affiliated to Dr APJ Abdul Kalam Technical University, Uttar Pradesh, Lucknow.
www.jssaten.ac.in
Department of Computer Science and Engineering
9. Mobile No:
10. E-mail:
11. Nationality:
12. Category Gen/SC/ST/OBC/PH:
13. GATE/NET (If applicable)
Branch
Year
Valid up to Percentile (& Score)
14. Educational Qualification (10th onward):
Qualification Subject/Discipli Board/Institute/ Year of
ne
Univ.
passing
10th
All India Rank
% of
mar
ks
Divis
ion
12th
Diploma, if
any
M.sc/M.C.A/
B.E./B.Tech
M.E./M.Tech
15. Research Publications (if any): Enclose a separate sheet
16. Details of Experience in chronological order (if any): Enclose a separate
sheet
17. Any other information: Enclose a separate sheet
JSS MAHAVIDYAPEETHA
JSS ACADEMY OF TECHNICAL EDUCATION, NOIDA
Approved by All India Council for Technical Education (AICTE), New Delhi.
UG programs are Accredited by National Board of Accreditation (NBA), New Delhi.
Affiliated to Dr APJ Abdul Kalam Technical University, Uttar Pradesh, Lucknow.
www.jssaten.ac.in
Department of Computer Science and Engineering
DECLARATION
I hereby declare that all the statements made in this application are true and
complete and nothing has been Concealed/Distorted. I am aware that, if at
any time I am found to have Concealed/Distorted any material information,
my engagement is liable to be summarily terminated without notice.
Place:
Date:
Signature of the
Applicant
Checklist1. Proof of Date of Birth
2. Mark sheets & Certificates of all the examination passed(SelfAttested)
3. Uttar Pradesh Domicile Certificate
4. Experience Certificate, if any
5. Self-Attested copy of documents