NAME IN CAPITAL LETTERS [as in the SSLC certificate] *

SEX *

DATE OF BIRTH *

AGE

PLACE OF BIRTH

DISTRICT

RELIGION

COMMUNITY

PHYSICAL DISABILITY : Yes No

PERMANENT ADDRESS *

CONTACT ADDRESS

EMAIL *

PHONE NUMBER (LANDLINE)

MOBILE NUMBER *

WHATSAPP NUMBER *

POSITION SOUGHT FOR *

DEPARTMENT *

PARENT DETAILS

PARENTS	NAME	EDUCATION	OCCUPATION	REMARKS

MARTIAL STATUS

HAVE YOU APPLIED FOR ANY OTHER JOB?

IF APPOINTED,MINIMUM PERIOD OF ASSURED SERVICE *

IF YOU ARE APPOINTED , WHAT IS YOUR INSPIRATION FROM OUR VISION AND MISSION STATEMENTS AND WHAT COULD YOU CONTRIBUTE TOWARDS ACHIEVING THEM *

LANGUAGES KNOWN:

LANGUAGES KNOWN:	READ	WRITE	SPEAK

EDUCATIONAL QUALIFICATIONS (ENCLOSE ATTESTED COPIES OF CERTIFICATES): *

EMPLOYMENT HISTORY / POSTDOCTORAL (BEGINNING WITH THE LATEST):

ORGANISATION	DESIGNATION	FULL TIME/PART TIME	PAID/HONORARY	IF PAID,SCALE OF PAY	PERIOD	NAME & PH. NO.OF SUPERVISOR

PUBLICATIONS (ENCLOSE COPIES):

INTERNATIONAL	NATIONAL (Nos.)	REGIONAL	PROCEEDINGS WITH ISSN	ANY OTHER

AWARDS AND RECOGNITIONS (ENCLOSE COPIES):

INTERNATIONAL	NATIONAL (Nos.)	REGIONAL	PROCEEDINGS WITH ISSN	ANY OTHER

DETAILS OF EXTRACURRICULAR ACTIVITIES :

REFERENCES (NAME & PHONE NUMBER):

NAME	PHONE NUMBER

I hereby declare that the information furnished above is true to the best of my knowledge.

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