* Required fields |
Faculty * |
: |
|
Registration / Employee ID |
: |
|
Name (Initials at the end) * |
: |
|
Date of Birth (dd/mm/yyyy) * |
: |
dd
mm
yyyy
|
Sex * |
: |
|
Maritial Status * |
: |
|
Designation * |
: |
|
Department* |
: |
|
Category * |
: |
|
Father's Name (Initials at the end) * |
: |
|
Husband's Name (Initials at the end)* |
: |
|
Address part 1 / Door No. & Street * |
: |
|
Address part 2 / Street & Area * |
: |
|
Address part 3 / Area & Region |
: |
|
City * |
: |
|
State / Region * |
|
|
Country * |
|
|
Pin Code |
: |
|
Contact Mobile Number * |
: |
|
Official E-Mail ID * # |
: |
# Official email ID given by SRMIST (For Researchscholar : Student Email)
|
Personal E-Mail ID |
: |
|
Date of Joining in SRM (mm/dd/yyyy) |
: |
|
PAN Card Number |
: |
|
|