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Sir Padampat Singhania University, Udaipur

Application for the post of_______________________

Advertisement No. ______________

1 Name of the Candidate:

2 Fathers/Husband Name:
Photograph
3 Mothers Name:

4 Date of Birth:

5 Marital Status:
6 Nationality:
7 Sex: Male Female
8
Address for Correspondence:
(mention e-mail & telephone nos.)

9 Permanent Address:

a) Whether the applicant belongs to Yes No


SC/ST/OBC/Physically Handicapped
10 b) If yes, please write category to which you belongs:
11 Qualification from 10th standard onwards:
Examination Board/ University Year % of marks Division/ Subject
Class

12 Specialization:

13 Experience (in years)


Designation Organization Period Salary Nature of Job
From To drawn

14 No. of Papers Published National


(enclosed list of publications) International

15 Seminar/Conference/Workshop/ National
Training programme attended International
(enclose list)

16 No. of Book(s) Published Authored


(enclose list) Edited

17 Research Project completed/ Perusing


S. No. Title of the Project Sponsoring Agency Period No. of Amount
Research (Rs)
From To Staff

18 Conference/Training/Workshop Organized

Name of the Conferences/ Sponsoring Agency Period Amount No. of


Training/ Workshop From To Sanctioned Participants

19 Patent filed
(give detail)

20 Any other information in support of


your candidature
21 References
(At least two names and address
including e-mail & phone numbers of
the referee)

Date:
Place:

(Signature of the candidate)