Nehru Library - Employee Registration Form

ℹ️

Instructions: Fill in all required fields marked with *. Attach a recent passport-size photograph. This form is for both active and retired employees of the university.

📸 Photograph

Attested Photo
(Passport Size)

Upload Photograph

📌 Please upload a recent passport-size photograph (JPG, PNG format)

👤 Personal Information

Library ID Number

Name (in CAPITAL LETTERS) *

Designation *

Department / College *

📅 Important Dates & Identification

Date of Birth *

Date of Superannuation

Blood Group

Unique ID / PPO Number *

Allergic to Medicine (if any)

🆔 Government Identification

Aadhaar Number *

PAN Number

📞 Contact Details

Permanent Address *

Contact Number *

Official Email ID *

👨‍👩‍👧‍👦 Family Information

Spouse Name

Spouse Age

Dependents Information

📝 Undertaking & Signature

I undertake to abide by the Rules of the University.

I also undertake to obtain 'No Dues Certificate' from the Library at the time of leaving the University.

Date:

Signature of Applicant

🏢 Recommendation of HOD/Office

Certified that Dr./Mr./Ms. is/was an employee of this department/Office. The particulars given by him/her overleaf are correct. It is therefore, recommended that he/she may be allowed for Identity Card / Identity Card (for Retd.).

Date

Seal/Stamp

HOD Signature

📚 NEHRU LIBRARY

CCS Haryana Agricultural University, Hisar

🏢 Recommendation of HOD/Office