A SELF-FINANCED ISO 9001:2008 CERTIFIED INSTITUTE

APPROVED BY AICTE & AFFILIATED TO KURUKSHETRA UNIVERSITY, KURUKSHETRA)

(CHHOTA BANS), RADAUR- 135 133 (YAMUNA NAGAR)
Phone: 01732-284195, 284779, 284799, 94160-07488 Fax No. : 283800
Website: www.jmit.ac.in E-mail. principal@jmit.ac.in

Date: 15/03/2015
1.

Post Applied for ASSISTANT PROFESSOR CHEMICAL ENGG.

2.

Name in Block letter: MITHELESH KOUL

(a)

Date of Birth: 16/05/1990

(b)

Place of Birth: JAMMU

(c)

Nationality: INDIAN

(d)

Blood Group: B + (e) Identification Marks: MOLE NEAR LEFT EYE

(f)

PAN No: BRSPK8849K

Sex: MALE.
Driving License No: NA

Passport No: NA

Aadhar Card No: NA

3.

Present Postal Address ( in block letters): H.NO 16/1, SHARDA COLONY, PATOLI

BRAHMNA. AKHNOOR ROAD, JAMMU (J&K)

PIN CODE: 181205

Mobile No.7896374444 E-mail: mithelesh.dcrust@gmail.com

4.

Permanent Home Address (in block letters)-DO-..

...
..Pin Code...
PhoneMobile No...E-mail ....

5.

(a) Fathers Name : MOTI LAL KOUL

Mothers Name: LAJWANTI KOUL

(b) Name of Husband/wife (if married)

(c) Details of Family
6.

Category: GENERAL

7.

a) Present designation & name of employer (if employed): WORKING AS TEACHING

ASSISTANT IN SVNIT SURAT

b) Grade and consolidated salary being drawn .30k...
8.

Have you ever been prosecuted, kept under detention, fined, convicted by a Court of Law
for any offence or debarred/disqualified by any University, Public Service Commission
from appearing at its examinations/selection? Is any case pending against you in any
Court of law at the time of filling up of this application form? If the answer is Yes full
particulars of the case, detention, fine conviction, sentence etc. should be given.

NO

9.

Educational Qualification (from Matriculation onwards):

Sr.
No
.

Exam. Passed

1.
2.
3.

Matric
10+2/Diploma
B.Tech.Chemical engg

4.

Universit Institute Name

y/ Board

JKBOSE
JKBOSE
DCRUST
IIT
M.Tech. Chemical engg Guwahati

Year of
Passing

Marks %

Regular/Cor
respondence
/Part time

MIER Jammu
MIER Jammu
DCRUST

2006
2008
2012

90.4
84.66
69.25

REGULAR
REGULAR
REGULAR

IIT Guwahati

2014

86.5

REGULAR

10.

Topic of M. Tech Dissertation: THERMOCHEMICAL CONVERSION OF WASTE

BIOMASS TO LIQUID FUEL

11.

Topic of research for Ph.DNA

Field of specialization

12.

Experience:

Employers Name &

Address

NA
Institute/
Industry

Duration
From
To

Total
Period

Nature
Duties

of Emoluments
& Scale etc.

Reason
For
Leaving

Please specify whether you have ever worked in any Mukand Lal Institution.
NO
Total experience: Under Graduate Classes..Yrs.

Post graduate Classes Yrs.

Results of classes taught by you:- NA

Semester :
Year:
Subject
%

13A.

Semester :
Year:
Subject
%

Semester :
Year:
Subject
%

Semester :
Year:
Subject
%

Paper published in Journals..

Nos.

National

International

Free

Paid

Free

ISSN No.

Impact
factor/references if any

0165-2370

3.070

Paid
2

B.

Papers presented/published in Conferences

Nos.

ISSN No. of proceedings

National
International
Attach a list of publications is respect of each category mentioned above.
C.

No. of books published..

Detail of publishers. ISSN No.

D.

Detail of Patents..

14.

Extra Curricular Activities (Sports, Social, Literary Activities, N.C.C./N.S.S.) etc.

Name
Activity
1

of Level/Name of the Competition

Year

Position Achieved

2014

NA

CHEMICAL ENGG SYMPOSIUM

IICHE QUIZ AT DCRUST
2011
OYCE (ORGANISED BY IICHE) IN 2011

3RD
NA

POSTER PRESENTATION AT
REFLUX- THE ANNUAL

2
3

MUMBAI

15.

Conference/Seminar attended/ organized by you: (Attach list) NA

Conference

Name
Conference

of Place

Date

Sponsored/Faculty

National
International
16.

Any other achievement you would like to mention:

MEMBER OF IICHE, C AND C++

CERTIFIED COURSES
17

Have you ever been connected with any political party? If so give details NO
Do you have any contract/ bond with your present employer ? if yes, give details NO
Do you consume liquor ?

: Yes/No

NO

Are you used to gambling ?

: Yes/No

NO

Do you have any relative working in Seth Jai Parkash Mukand Lal Institutions of Knowledge
and Service for any relation with any member of the Managing Committee (if yes, furnish
details)
..
NA
3

Please state whether you are pursuing any course of studies at present? If yes , give details
.NA
Please note that:
(a)
You will not be allowed to undertake any further studies during your employment without
prior written permission of the competent authority.
(b)

You will not undertake any part-time job including coaching/tuition etc.
If selected, when can you join ?
: YES
Salary Acceptable

: 45 k

Name & Addresses of two references, not relatives:

Dr. K. Mohanty

Mr. S.K Sharma

Associate Prof chemical engg

Assistant Professor Chemical engg

IIT Guwahati

DCRUST, Murthal (Haryana)

Guwahati- 781039

pin: 131039

I declare that the information given above is true and correct to the best of my knowledge and
belief & nothing has been concealed therein. I am aware that any false or incorrect information
by me may result in termination of my service with the institute. I have no objection, if you
enquire from any of my previous employers on any matter pertaining to me, if I join your
institute.
Place: Surat
Date: 15/03/2015

Mithelesh Koul
(APPLICANTS SIGNATURE WITH DATE)