Professional Documents
Culture Documents
Gandhinagar-382007
Date: __________________
_____________________________________________________________________________
Post Applied for
__________________________Subject: ______________
Passport size
photograph
___________________________________________________________________
1. Name in Full:
_____________________________________________________
(Capital letters only)
(Surname)
(First Name)
(Last Name)
2. Address:
For Correspondence:__________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
City: ______________________ District: _______________________ Country: __________________
Permanent: __________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Phone: ________________ Mobile No.: ________________ e-mail: ____________________________
3. Date of Birth: ___________________ 4. Nationality: _________________ 5. Sex:
M/F
6. Present Status:
Designation: __________________________________________________
Organization: _________________________________________________
Total Emoluments:_________________________________________
7. Areas of Specialization: ________________________________________________
8. Current Areas of Research: __________________________________________
9. Academic Record (starting with Bachelors Degree)
(Please attach photocopies of degree certificates and also brief synopsis of the Masters & the Doctoral thesis)
Degree
(Subjects)
Institution
Year
Marks &
Division
Remarks
Page 1 of 6
11. Category:
(Attach a certificate from the authority prescribed under government rules for ST/SC/ SEBC category)
Total Pay
(pm)
Duration
From
To
Total
Experience
From______________ to _____________
Name of Subjects:
_____________________________________________
_____________________________________________
_____________________________________________
From______________ to _____________
Name of Subjects:
____________________________________________
____________________________________________
____________________________________________
_____________________________________________
From______________ to _____________
Name of Subjects:
____________________________________________
____________________________________________
(i)
Total
Experience
____________________________________________
____________________________________________
____________________________________________
Page 2 of 6
B3. Consultancy:
Duration
Sponsoring
Organization
Title of Project
Amount of
Grant
Area of Project
Co-Investigators
(if any)
C. Publications:
No. of Research Papers published in journals.
(i) In Refereed Journals:
No. of Publication
International
National
* Cumulative total of impact factor of all the publications in Referred journals
(ii) In Proceedings of Refereed (i) International: _______________________________
Conferences
Note: Please attach the summary on separate sheets for publications in refereed journals and referred conferences papers
including all details. (i.e. Title, Year, Vol., Page No. Name of the Publisher (may be mentioned) & Impact factor.) Along
with this details also attach the Reprints of published best three research Papers, Journal/Proceedings of Conference in last
five years.
D. Industrial Experience:
Duration
Organization
Nature of Work
Total Pay (pm)
Designation
Page 3 of 6
________________________________________________
________________________________________________
________________________________________________
________________________________________________
________________________________________________
16. Give Names, designation and addresses of three persons (not related to you), to whom
reference may be made about your work, conduct & performance.
(i) _________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Email: ____________________________________________ Contact No.: ______________________________
(ii) _______________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Email: ____________________________________________ Contact No.: ______________________________
17. If not found eligible, as per university norms for the position you have applied for, would you
like your candidature to be considered for lower position: . Yes / No
18. State any other information not covered elsewhere (Please attach a sheet, if required)
___________________________________________________________________________________
___________________________________________________________________________________
19. Minimum time duration for joining: ________________________________________________
DECLARATION TO BE SIGNED BY THE CANDIDATE
I hereby declare that the details given above are correct to the best of my knowledge and belief. I
understand that if any information provided above is found to be false or inaccurate my candidature shall be
treated as cancelled at any point of time.
Date:
(Signature)
Name:.......................
Page 4 of 6
General Instruction
(For candidates interested in a faculty position)
1. Candidates applying for a position to more than one department are required to use separate application
forms.
2. (a) On the first page of the Application Form (column 1 to 11), the desired particulars are to be filled
in by the candidates supported by certificates and documentary proofs (where necessary)
(b) On the second page (column 12) separate sheet (s) for each sub-heading in the format is/are
indicated to be used indicating cross references in the columns provided and the annexures attached
(c) All annexure and the application form must bear full name and signature of the candidate on each
page at the bottom.
Page 5 of 6
Summary
Post Applied for:
Name of the Candidate:
Address:
Date of Birth:
Qualification:
Nationality:
Year
Percentage/grade
Ph.D.
Title:
Master Degree
Title:
Bachelor Degree
Teaching Experience:
Present Position:
Designation: __________________________________________________
Research Experience:
(Excluding Research done for M.Tech /Ph.D.)
No. Publications:
In Referred
Journal
*Total Impact
Factor
M. Tech.
Conference/
Seminar
Ph.D.
Books
Consultancy
Funding
Agency
Budget Fund
Funding
Agency
Budget Fund
(Rs. Lakhs)
(Rs. Lakhs)