APPLICATION FORM - 2023

TUTOR (on Contract basis)

(Please download two copies and submit at the College) AFFIX PHOTO

Name of College applying for: ___________________________________________

Degree: M.SC.,: Speciality: ______________________________________________

Name of College and Place (M.Sc.): _________________________________________

Local Category: ________________Other State: ________________

1.Name of the Candidate :_________________________________________

(Full Name in block letter including surname)

2.Email-id :__________________________________________

3.Phone / Mobile No. :__________________________________________

4.Address for communication :__________________________________________

____________________________________________

_______________________Pin code :____________

5. Sex: Male/Female 6. Community: OC/BC-A/B/C/D/ SC/ST

7.Date of Birth (DD/MM/YY) :

8. Age in years and months :______________________________________

( as on 1-02-2023)
9.Permanent Address
_______________________________________

___________________ Pin code: ____________

Contact No: _______________________________________

10. Total Marks obtained in the M.Sc. exam :____________(out of) _______

11. Details of the Teaching experience till Date:

(Please attach attested copies of experience Certificates)

Name of From To Total Experience

Designation Department
Institution (DD/MM/YY) (DD/MM/YY) in Years & Months

SUBMIT ONE SET OF ATTESTED PHOTOCOPIES OF DOCUMENTS AS PER THE LIST OF ENCLOSURES
MENTIONED BELOW ALONG WITH THE APPLICATION FORM.
1. SSC Certificate/ Birth Certificate (Proof of Age)
2. Study/ Bonafide certificate 1st to 7th Class (as per the new presidential orders 2018)
3. Degree certificate
4. M.Sc. Certificate with Marks Memo
5. Copy of experience certificate in Medical Colleges along with appointment and relieving orders
6. Recent Passport size colour photos
7. Photo ID proof issued by the Government: Passport/Voter ID/ Aadhar card
8. PAN Card and Aadhar Card

Signature of Candidate