VIDYAMANDIR SOCIETY Smt.TANUBEN & Dr.MANUBHAI TRIVEDI ... · 5 All The Marksheet Of Post Gradution...
Transcript of VIDYAMANDIR SOCIETY Smt.TANUBEN & Dr.MANUBHAI TRIVEDI ... · 5 All The Marksheet Of Post Gradution...
VIDYAMANDIR SOCIETY’S
Smt.TANUBEN & Dr.MANUBHAI TRIVEDI COLLEGE OF INFORMATION SCIENCE
Z.F.Wadia Women’s College Campus, Website : www.vidyamandirsoc.org
Jawaharlal Nehru Marg,
Athwalines, SURAT 395 001.
JOB APPLICATION FORM
[Fill up all the details correctly & carefully]
Date of advertisement : _____________________________________________
Name of Institute: __________________________________________________
Applied for the Post of : _____________________________________________
Department : ____________________________________________________
1. (i) Full Name (in block letters) : _______________________________________________________
(as in HSC Mark Sheet)
(ii) Father’s / Name : _______________________________________________________________
(iii) Mother’s Name : ________________________________________________________________ 2. Present Address : __________________________________________________________________
_________________________________________________________________________________
___________________________________________________________ Pin ___________________
3 Permanent Address : ________________________________________________________________
_________________________________________________________________________________
___________________________________________________________ Pin ___________________ 4 Phone No. :Res with STD Code : ___________________________ Mobile: _____________________
✓ Pan card: _______________________ (Its Compulsory).
✓ Aadhar Card no: _______________________ (Its Compulsory).
✓
✓ E-mail ID : _______________________
________________________________________________________
5 Date of Birth : ________________________ Age [(as on date) completed years] _________________ 6 Nationality : ___________________ Gender: Male / Female Marital Status: Married / Unmarried
✓ Native Place: _______________________________________ (Town, Village, District & State).
7 Religion: ____________________________ Caste: ____________________________________
E- mail : [email protected]
Phone No.: [0261] 2460995
Please Affix Recent Passport Size Photograph
8. Do you belong to (Please tick) : OPEN SC ST SEBC
If yes, Whether certificate attached from :Certificate in Hindi / English / Gujarati competent authority (please tick) Physically Handicapped: YES / NO.
9. Educational Qualification: (All Details are Compulsory Filled)
Education Board/Uni. Passing Percentage CGPA Class Subject with
Year (%) Specialization
S.S.C.
H.S.C.
U.G. __________
P.G. __________
M.Phill
Ph.D.
NET/SLET Score
Other
Attach self attested Photo copies
10. Post held at present
Post held at Date of Nature of the Post (Temporary / Name & Address of
present Appointment Probation/ Permanent) Employers
Note: Please Attach No Objection Certificate (NOC).
11. Prizes, Awards, etc. : _______________________________________________________________
12. Academic Experience Details : (From Present to Past)
Sr.
Post
Total Length of
Employer’s Name Pay Scale Service (date) Nature of work No. held Emolument
From To
1
2
3
4
5
6
13 (a.) U.G. _________________ Year(s) _________________ Month(s)
P.G. _________________ Year(s) _________________ Month(s)
Total Experience _________________ Year(s) _________________ Month(s)
Other (if any) _________________ Year(s) _________________ Month(s)
(b) Research Activities:
Sr. Degree Registered / Duration
University / Funds Present (date)
No. Project under taken Sponsoring Authority sanctions Status From To
(c) Publication: No of Books Published__________________________________
National Journal
Sr. Name of Journal Volume No. Month / Year Title (in short)
No.
International Journal
Sr. Name of Journal Volume No. Month / Year venue Title
No.
Conference / Seminar
(Applicable if full text of paper is published)
Sr. Name of Conference / Seminar Month / Year Venue Title
No.
National Conference/ Seminar
International Conference/ Seminar
(d) Other Activities:
(i) Number of Expert Lectures Delivered : ___________________________________________
(ii) Number of Summer / Winter schools / Training Programmes : _________________________
Organized
(iii) Number of Seminar / Conference / Workshop / Networking : __________________________
Programme Organized
Administrative & Community Services: (e.g. Dean/ Vice-Principal/ Principal/ Hostel warden/
HOD/ Prof. Incharge/ Chairman, Board of Studies/
Self Development Programmes for community
Services)
Sr. Name of Assignment Duration Name of responsibility shared / service offered
No.
14. Member of Technical Societies : _____________________________________________
_____________________________________________
15. Extra Curricular activities / Hobbies : _____________________________________________
DECLARATION
I declare that the statements made in this application are true to the best of my knowledge and belief.
I understand that misleading or wrong information supplied may lead to summarily rejection of application / appointment if found subsequently.
Date: __________________
Place: _________________ (Signature of Applicant)
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WITHOUTFAIL FILL UP THE FOLLOWING DETAILS CAREFULLY
Name: __________________________________________________________________________
Correspondence Address: _________________________________________________________
________________________________________________________________________________
____________________________________________________ Pin ___________________ _______
Phone/Mobile No. : _________________/ _________________/ _________________
Document attachment
Sr. Document Yes/No Sr. Document Yes/No
No No
1 S.S.C. Mark sheet 8 NET/SLET Score
2 H.S.C. Mark sheet 9 M.Phill Certificate
3 Leaving Certificate 10 Ph.D. Notification/Certificate
4 Graduation Mark Sheet (All) 11 Experience Certificate (All)
5 Graduation Certificate 12 Research and Publication
6 Post Graduation Mark Sheet (All) 13 Paper Presentation
7 Post Graduation Certificate 14 Aadhar Card Copy
Document to be attached:
1 MARKSHEETS ✓
1 HSC
2 First Year
3 Second Year
4 Third Year
5 All The Marksheet Of Post Gradution
2 Leaving Certificate
3 Caste Certificate
4 Net / Slet Certificate
5 Ph.D / M.Phil Certificate / Notification
6 All The Teaching Experience Certificate
7 No Objection Certificate From Current Employer
8 Other Certificates / Achivement
9 Score Card Proforma
10 Self Address Envelope With Postal Stamps Worth Rs.25 -Affixed there on
11 Passport Size photo Affixed on Application.
12 Submission of form to be made in 3 copies with all relavant documents