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
