NICT Employee Self Registration Form
Personal Details
Instructions:
1) Fields with
*
are mandatory
2) You are requested to fill your official E-mail address correctly. You will get login and password information for daily MIS portal on your official E-mail
Name
*
Mother/Father/Husband Name
*
Relation
--Relation--
Mother
Father
Husband
Gender
--Gender--
Male
Female
Present Address
*
Permanent Address
*
(R) Telephone
STD Code
Number
Mobile Number
*
Without +91 or leading 0
Official E-mail
*
Office Location/City
*
Date of Birth
*
( DD / MM / YYYY )
Blood Group
*
-- Select Group --
O+
A+
B+
AB+
O-
A-
B-
AB-
Joining Date
*
( DD / MM / YYYY )
Reference
*
Name
Mobile
Without +91 or leading 0
Educational Qualification
S.No.
Level
Name of Degree/Diploma
Stream
Board/University/Organization
Year of passing
Division/Grade
1
Graduation
2
Post Graduation
3
Diploma / Certification / Other
I hereby declare that the information provided above by me is true.
*
