GOKUL TECHNICAL CAMPUS

SUJANPUR PATIYA, State Highway No-41, Sidhpur-384151, District-PATAN, GUJARAT.

Post appliedfor : _
Department/Subject :
A. PERSONAL DETAIL:

NAME: :
(SURNAME) (FIRST NAME) (FATHERS NAME)

MOTHERS NAME :

DATE OF BIRTH :
(DATE) (MONTH) (YEAR)

Age : Years

Marital Status : Married Unmarried Other
(Please Tick)
Email ID : ,

B. Addresss:
Present Permanent




Pin Code: Pin Code:
Phone No: Phone No:
Mobile: Mobile:




Institute :_____________________


C. EDUCATION QUALIFICATION:
BOARD/UNIVERSITY PERCENT CLASS YEAR BRANCH
SSC
HSC
DIPLOMA
B.E/B.Tech
M.E/M.Tech
Ph.D
Others

D. EXPERIENCE DETAIL:
Total Teaching Experience : Years Months
Total Professional Experience : Years Months
Name Of Present Employer :
Contact NumberOf Present Employer :
Can we refer to your present employer? (Please tick) YES NO
E. Academic Achievement :
1. Number of papers presented :
2. Number of books published :
3. Number of post graduate theses guided :
4. Number of teaching aids developed :
5. Number of consultancy projects undertaken :

F. General:
1. Number of membership of professional bodies or social organization :
2. Number of seminars, workshops, Conferences and training programs attended :
3. Number of awards won :
4. Number of prizes won in sports:
State Level :
National Level :
5. Hobbies: (1). (2).





6. What is your present salary - a. Pay scale :Rs.
b. Present Basic pay :Rs.
c. Total Emoluments :Rs.

7. Why do you choose this institution to work?


8. Mention your expected salary and other perks per month.


9. Earliest date of joining, if selected :

10. References (not relatives of the applicant) :
Sr. No. Name Address Contact No
1

2


G. Attach Self attested Copies of following in order and send them to above address (on header)
Before last date.

1. Mark sheet of bachelor degree
2. Bachelor degree certificate
3. Mark sheet of master degree
4. Master degree certificate
5. School leaving certificate
6. HSC mark sheet
7. PAN Card








Declaration to be made by the applicant
I hereby solemnly declare that all information given above is true to my knowledge.

----------------------------------
(Signature of the applicant)

Place:
Date:



For office use only

The candidate is selected for
The post of :
Salary/Scale of :Rs. Per Month.
Probation Period of : Years.



Authorised Signatory