Nirankari Baba Gurbachan Singh Memorial College,

Sohna
JOB APPLICATION FORM (TEACHING POST)
Name of the Post with specialization ____________________________________
Department ________________________________________________________

(For office use)

Dairy No._______
Date ___________

A. Name in Full(In block Letters) Mr./Mrs/Ms ___________________________

Fathers Name: Mr._______________________________________________
Date of Birth: ____________________ Place of Birth: ___________________
Nationality: ______________________ Marital Status: __________________

Affix recent
passport size
photograph

Category(General, S.C., S.T., B.C., Others) :___________________________

B. Address :
Permanent Address (in block letters):__________________________________________________________
________________________________________________________________________________________
Present Address: (for Correspondence) (in block letters): __________________________________________
Any change be intimated to the office _________________________________________________________
Phone/Mobile No._________________________________ E-mail:_________________________________
C.

Minimum Pay acceptable:_______________________ Joining time (If Selected)__________________

D.

Education Qualification: (Please attach one set of attested copies alongwith orginal application only)

Examination/Degree

Matric
10+2
Diploma:
Graduation:
Post Graduation :
M.Phil.:
Ph.D.:
7. Any other Exam.
(please specify):

Univ/Board

Main
Subject

Year of
Passing

Marks
Obtd./
Max
Marks

Class/Divn. Merit/Prizes/
/Grade
medals
(attach
Won if any.
conversion
formula)

E. Professional Training:
S.No

Organization

Period
From

Details of Training
To

F. Employment Experience (details in chronological order, starting with first job:

Name & Address
Employer/
Institution

Date

Designation

Nature of
job

Joining Leaving

Basic Pay p.m.

& Grade
Pay/Pay Scale

Reasons for
Leaving

G. Total Teaching Experience ___________________________________________________________

Subjects Taught

Period

(i) Postgraduate Classes

______________________________

From
____________

To
___________

(ii) Degree Class

______________________________

____________

___________

(iii) Any Other

______________________________

____________

___________

H.

Details of Research work

Period

(a)

Own Research work

_____________________________

From
____________

To
___________

(b)

Supervising Research

______________________________

____________

___________

(Annexure if any, should not exceed 100 words)

I. Publication (please enclose list specifying whether they are of National or International Level):
Description

Published

In
Press

Accepted
for
Publication

References of citation of the work in

journals
/Reviews, if any, may be given.
Use separate sheet, if necessary.

(a) Books
(b) Research Papers
(c) Articles
(d)
(e)
J. Seminars/Conferences/workshops/Refresher Courses etc. Participated and sessions presided over the past five years.

K. Knowledge of computer software :

________________________________________________________________________________________________
L. Membership of Professional Societies, if any:

M. National/International Awards

N. A paragraph of self-evaluation regarding different fields of activity relating to the job :

O. References:
These should be professionally competent persons, well acquainted with some aspects of the applicants training,
accomplishments, capability and character but must not be relations. At least two of them should be citizens of India, for
applicants having done post-graduate or post-graduate or post-doctoral research supervisors must be listed. Supervisor
of each major employment and present or most recent employment must be listed.
Name
Occupation/position
Address
1._____________________________________________________________________________________________
2._____________________________________________________________________________________________
3._____________________________________________________________________________________________
P. Additional Information: (No annexure need be enclosed)

Q. List of Enclosures:
1.------------------------------

2.------------------------------ 3.------------------------------ 4.------------------------------

5.------------------------------

6.------------------------------ 7. Draft No.---------------Dt. ----------- Amount---------------

R. Declaration: I solemnly declare that:

I.
II.
III.
IV.

The foregoing information is complete and correct. I am not aware of any circumstances which may impair my
fitness for employment in the Abohar Polytechnic College, Abohar
I have never been disqualified from University work/ appearing in any University examination.
I have never been dismissed either from Govt. ot from University, College or other public or Private
Organization service.
I have never been prosecuted, kept under detention or bound down/fined, convicted by the court
Law for any offence.

Place : ----------------------------Date : -----------------------------

----------------------------------Signature of Applicant