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 Advertisement No. : 04/2019
Application Lock Time ::

APPLICATION FORM FOR NON-TEACHING POSITION

To,
The Registrar,
Chaudhary Ranbir Singh University,
Rohtak Bye Pass Road, Jind (Haryana)-126102 000000801108

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Control Id : 801108
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SDO (Civil) Post Code : 2
Name SANJEEV KUMAR
Father's Name ARBIND KUMAR
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Mother's Name SAVITRI DEVI
Gender Male
Marital Status Married Have more than one living wife/husband: No
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Correspondence Address HOUSE NO F-110 LADO SARAI NEAR RELIANCE

FRESH STORE DELHI Delhi - 110030
Permanent Address SAMPAT BHAWAN, DAK BANGLA ROAD BARBATTA,
SONPUR NEAR SONPUR POWER HOUSE SARAN -
841101
Phone No. (Residence) with STD
Mobile No. 9654132005
Email Id sanjeev2812@gmail.com
Aadhar No. 353967861469
Date of Birth: 21/01/1984
Place of birth with name of District and State Sonpur, Saran, Bihar
Nationality Indian
Domicile State Bihar

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 Category UR
(A) Whether Ex Serviceman No
(B) Whether Physically Challenged / PWD No
(B) 1: If Yes, give the Category N.A.
(B) 2: Mention the Percentage of Disability N.A.
Have you ever been disqualified from appearing in No
any University examination/assigning University
work?
Have you ever been dismissed from any job? No
Have any criminal case has been registered against No
you?
Have you ever been charge-sheeted for any No

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criminal offence?
Have you ever been convicted by any competent No
court of law for criminal offence?
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Typing speed (words per minute, if applicable for In English : , In Hindi :
the post)?
Have Shorthand speed of 120 WPM and accurate No
computer typing speed of 45 WPM (if applicable
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for the post)?

Extra-Curricular Activities/ Achievements:
(Maximum 05 marks)
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Languages known

Language Speak Read Write

Hindi. Yes Yes Yes
English. Yes Yes Yes
. No No No
. No No No

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 Details of Educational Qualifications

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Exam Year Board/University Institute Max Obt. Perc Division / Subject/Title Specialization
Marks / Marks / entage Grade

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CGPA OGPA
SSC / 10th / 1998 BIHAR SCHOOL HIGH SCHOOL 700 467 66.71 1ST HND SNK MATH SCIENCE &
Matriculation EXAMINATION BOARD CHAPRAMEG MATH SCIENCE COMMERCE
PATNA
HSC / 12th 2000 BIHAR INTERMEDIATE LS COLLEGE 900 645 71.67 1ST HIND, ENG, PHY, SCIENCE

B.Tech. 2009
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EDUCATION COUNCIL
COCHIN UNIVERSITY OF SCHOOL OG
SCIENCE AND ENGINEERING
8000 5185 64.81 1ST
CHE MAT
CIVIL
ENGINEERING
CIVIL
ENGINEERIN
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TECHNOLOGY G
Other PGP IN 2010 NICMAR NICMAR 10 6.04 60.4 1ST CONSTRUCTION CONSTRUCTI
ADVANCE MANAGEMENT ON
CONSTRUCTI MANAGEME
ON NT
MANAGEME
NT
M. Phil.
Other-1
Other-2
Ph.D. Details Date of Date of Award of Degree Title of Thesis University / Whether Ph.D. degree is according to UGC
Registr Institute regulations 2009/2016
ation

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 Present position : Permanent

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Post with details of organization Date of Appointment Pay Band / Grade Pay Basic Pay Total Emoluments Nature of Job
/ Pay Level

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Appointments held before joining the present post

Sr Post with details of organization Date of Appointment Pay Band / Basic Pay Total Nature of Job Leaving Reasons for
No Grade Pay / Emoluments Date leaving the Post
Pay Level
1 DLF LTD

M 01/06/2011 80,000/- PLANNING &

EXECUTION
20/11/2017 Personal
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2
3
4
5
6
7
8
9
10

(a). Total job experience in years 6 Year(s) 5 Month(s)24 Day(s)

(b). Job experience in years as required for the post 5
(c). Job experience in a grade equivalent or higher to the post applied 6
(d). Any additional relevant information you would like to furnish.

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 SELF-ASSESSMENT PROFORMA

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Sr. No. Particulars Self-Assessment Score* Verified Score**
1. Matriculation 3.5

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2. 10+2 7.5
3. Graduation 10
4. Post Graduation 12

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5. Relevant Experience 5
6. Extra-Curricular Activities / Achievements 0
Total 38
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Note: Supporting documents / evidence for claiming the score, wherever required are to be attached.
* To be filled by the applicant.
** To be verified by the Screening / Scrutiny Committee.

(Signature of the applicant)

(………………………….) (………………………….) (………………....)

Name & Signature Name & Signature Name & Signature

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 Application Fee Details

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Mode Status Amount
DO NOT ATTACH ANY DOCUMENTS SEPARATELY. SEND THIS APPLICATION FORM PDF PRINT ONLY.

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DECLARATION

I hereby declare that the information given above & in the enclosed documents are true and nothing has been concealed therein. I am aware of the fact that if

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information given by me is proved false/not true, I will have to face the criminal proceedings as per provision of the Law and all the benefit availed by me shall be
summarily withdrawn.
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Date Signature of the Applicant
Place:

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