APPLICATION FOR EMPLOYMENT IN THE INSTITUTION

(Please enclose Xerox copies of all educational qualifications, experience & other achievements)
1. Name of candidate

______________________________________________________________________________________
Surname
First Name
Middle Name

2. Category

B.C Candidates to enclose copy of cast certificate)

3 Date of birth

________________________(DD/MM/YYYY)

Male / Female

Married / Unmarried

4. Post applied for

Name of Post : ____________________________________________________________________

(Strike out which is not applicable)

(Strike out which is not applicable)

Department :
5. Address for
Correspondence

_______________________________________________________________________________
_______________________________________________________________________________
PIN

6. Contact No

STD code:

Phone Number :

7. Mobile No

_________________________

8 .E Mail

_________________________________________

9. Academic Qualifications (Fully completed examinations only)

Qualification

Branch/
Specialization as
applicable

SSC

Not applicable

HSC

Not applicable

Diploma
Degree
Post Graduation
Ph.D

Name of
Board/University

Year of
passing

Percentage
obtained

Grade/
Class/CGPA

10. Academic Qualifications (Appeared/in progress)

Qualification

Name of
Board/University

Expected Year of
completion

Percentage obtained
So far

Grade/Class
expected

11. Experience (In chronological order) (Candidate may attach separate sheet if required)
Name of Organisation

Nature of post held

(Teaching/Industrial)

Period served
From
To

Number of
years

Last pay
drawn
(Total)

Reason for
leaving

Total years of Experience

(a) Teaching : _____________

(b) Industrial : _____________

12. Any other achievements

___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
I hereby declare that all the information given above is true. I have enclosed the Xerox copies of all certificates / documents wherever
required. I shall produce the originals of these documents at the time of interview. I understand that no TA/DA is admissible for the
interview and I shall make my own arrangements for my travel/stay.
Date : _______________________

________________________________________________________
(Signature of the Candidate)

Place : ______________________

________________________________________________________
(Name of the candidate)