Necg Ratification Application

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    NARAYANA ENGINEERING COLLEGE::GUDURFORM OF THE APPLICATION FOR STAFF RECRUITMENT BY SELECTION

    (Last date for the s!"#ss#o$ of A%%'at#o$ )*)+*,)+-

    +. Post a%%ed for : De%t:

    ,. Na"e of the Ca$d#date #$ F&&:

    (I/Address for Corres%o$de$'e (II/ Off#'#a& Address

    Pho$e(R/: Pho$e (O/

    . Date of B#rth*A0e*Se1: 2M*F2 3. Co""$#t4: OC*SC*ST*BC

    5. P&a'e of B#rth: -.State:

    6. La$0a0e 7$o8$:

    S.NO LANGUAGES SPEA7 ONLY READ 9 SPEA7 READ;RITE 9 E

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    +,.Prese$t %os#t#o$(Des#0$at#o$/ :

    S'a&e of Pa4 : Bas#':Rs. Tota& E"o&"e$ts(%."/Rs:

    +.Deta#&s of E"%&o4e"e$t *E1%er#e$'e :

    Na"e a$d

    Address of Post he&d S'a&e of %a4 Fro" To   Bas#' %a4 Reaso$s for

    I$st#tt#o$ &ast dra8$   &ea>#$0 the

    F#r" or   %ostoff#'e

    +3. Ca$ 4o s!"#t Noo!e't#o$ 'ert#f#'ate fro" 4or %rese$t e"%&o4er #f se&e'ted :Yes*No*Not

    a%%'a!&e*#$ter$a&. #f NoG#>e reaso$s .

    +5.Deta#&s of e1%er#e$'e of e"%&o4e"e$t *resear'h *'o$t#$#t4 ed'at#o$ %ro0ra""es.

    (a/.Tea'h#$0 E1%er#e$'e #$ 'o&&e0e*U$#>ers#t4 P.G:Yrs UG:Yrs

    (!/.Resear'h %!'at#o$s :or$a&s: I$ter$at#o$a&:Nat#o$a&:

    Co$fre$'e: I$ter$at#o$a&:Nat#o$a&:

    ('/.Refresher 'orses atte$ted :

    (d/.I$dstr#a& E1%er#e$'e :Yrs

    (e/.Ad"#$#strat#>e E1%er#e$'e :Yrs

    Add se%arate sheet 8#th deta#&ed #$for"at#o$$der a$$e1res ABCD a$d E.

    +-.o#$#$0 t#"e reJ#red .If se&e'ted :   Mo$ths:IIIIDa4s:IIIIIE1%e'ted DoG:IIIIIIIIIII

    +6.E1%e'ted sa&ar4 : Tota& E"o&"e$ts(%"/Rs:

    +=.E1tra 'rr#'&ar a't#>#t#es : (se add#t#o$a& sheets #f reJ#red $der a$$e1re F/

    +.A$4 other re&e>a$t #$for"at#o$ : (se add#t#o$a& sheets #f reJ#red $der a$$e1re G/

    ,).Referees : ( the referees sho&d !e res#d#$0 I$ #$d#a ho&d#$0 res%o$s#!&e %os#t#o$ a$d $ot re&ated to the"/

    S.NO NAME OCCUPATION*POSITION ADDRESS*MOBILE NO.

    A

    B

    ,+.Deta#&s of E$'&osres: (I$d#'ate the e$'&. 8#th K/Tota& No.of Cert#f#'ates e$'&osed:

    a/ Date of !#rth 'ert#f#'ate f/De0ree "ars /Ph.D . Cert#f#'ate(OD/

    !/SSC*SSLC Mars 0/De0ree 'ert#f#'ate(OD/ &/ GATE*RF*NET*SLELT

    '/PUC*I$ter"ed#ate Mars h/P.G.Mars M/Ser>#'e Cerf#'ated/D#%&o"a Mars #/P.G.Cert#f#'ate (OD/ $/Sa&ar4 Cert#f#'ate

    e/D#%&o"a 'ert#f#'ate  /M.Ph#&&.'ert#f#'ate(OD/ o/Noo!e't#o$ 'ert#f#'ate

    %/A$$e1res(A*B*C*D*E*F*G/ J/other 'ert#f#'ates #f a$4

    Stat#o$: Ne&&ore S#0$atre of the Ca$d#date

    DECLARATION TO BE SIGNED BY THE CANDIDATE

    I here!4 de'&are that the state"e$ts "ade #$ th#s a%%'at#o$ are tre to the !est of "4 $o8&ed0e.

    Date: S#0$atre of the Ca$d#date