Enrollment No. :- ..............
C. U. Shah College of Engineering & Technology
(Managed By : Vardhman Bharti Trust) Surendranagar-Ahmedabad State Highway, Wadhwan City-363 030 Dist : Surendranagar. Fax : (02752) 242712 Ph. : 242711-12-13,294004
APPLICATION FOR EMPLOYMENT
Post applied for Department : : D.D. No. Name of Bank : :
-:: Personal Details ::1. 2. 3. 4. 5. Name Date of Birth : (Surname) : (Date) (Month) (Y e Marital Statue (Please Tick) Category (Please Tick) : : Married OPEN SEBC SC NT a r) Unmarried ST PH Permanent Others (First Name) Sex : (Fathers Name) Male / Female
Address : Address for Correspondence
Pin Code : Phone No. : Mobile No. : E-mail ID :
Pin Code : Phone No. :
6.A. Educational Qualifications : Examination University / Board Passed
Year of Passing
% of Marks
Div./ Class
Subjects / Discipline
B. 7.
Whether you have passed NET/SLET exam (Please Tick)
Yes
No
Details of Professional Experience : (after obtaining the basic degree till date of advertisement) A. Teaching & Research Experience : Name and address of Designation period of Nature employer service of service From To
Total Salary drawn p.m.
B. Industrial Experience : Name and address of Designation employer
period of service From To
Nature of service
Total Salary drawn p.m.
8.
Details of Research Work carried out : Degree Topic of the Research Project Period From To Institute Name of Guide
9.
Details of Research Work supervised : Topic of the Research Project Period From To Institute Name of the student
10. Details of Publications : A. Book / Monogram etc. Title
Month/Year of Publication
Name of Publisher
B.
Technical Papers Published/Presented/Communicated. Title Details of Seminar/ Conference in which Paper was presented Name of Date Organisation Month / Year of publication Name of Journal / Magazine Published/ Presented/ Communicated
C.
Technical Articles Published. Title Month / Year Name of Journal / Magazine
11. Details of STTP/Workshop/Seminar/Conferences attended. : Name of Programme Name of Organiser From Period To
Total
12. Any other information in support of the application (e.g. NCC/NSS/Games & Sports/Cultural etc.) :
13. A.
Present Pay Pay Scale Total emoluments p.m. Date of next increment
: : : :
Rs. Rs. Rs.
B. C.
Minimum Salary acceptable
Rs. :
Approximate time required for joining, if appointed
14. Names and Addresses of two references who are not related to the candidate but who are acquainted with the work and character of the candidate : (1) (2)
Phone : Mobile :
Phone : Mobile :
15. Enclosures : (Tick mark the documents from the following list)
No. 1. 2. 3. 4. 5. 6. 7. 8. 9.
Particulars of Documents Mark Sheet of HSC. School Leaving Certificate. All Mark Sheets of Bachelor Degree Degree Certificate of Bachelor Degree All Mark Sheets of Master Degree Degree Certificate of Master Degree Certificate of Ph.D. Experience Certificates. Proof of seminar / Conference / STTP attended etc.
Quantity
10.
Any other documents. i) ii) iii) iv)
I hereby declare that the information given above is correct to the best of my knowledge and belief.
Signature of Candidate Note :(i) The application should be submitted alongwith true copies of the relevant certificates so as to reach at the above address, on or before the last date shown in the advertisement. Enrollment No. given to you invariably be mentioned in application form. Additional sheets of paper may be attached if the space provided against any item is insufficient. The application should be forwarded through proper channel in case of persons who are already employed. Application received after the last date or incomplete application will not be considered. The management reserves the right to reject any application without assigning any reason.
(ii) (iii) (iv) (v) (vi)
For Office Use Only
SN 1. 2. 3. Designation Nature of service Pay Scale From To Mode of Selection
